A common question I have received since deciding to pursue a career in public health is “What is public health?” and “How does your interest in children with disabilities relate to the public health profession?”. Both questions are equally valid and worth exploring as the general population is often unaware the role a public health professional plays in their everyday lives. I think many people still have an image of the community public health worker travelling to neighborhoods to administer vaccines, checking on the sanitation of a local restaurant, and even linking families to resources in their communities to ensure food security. While these roles are still important in ensuring the wellbeing of communities, the role of a public health professional has expanded considerably.
Public health seeks to prevent poor health outcomes, such as chronic disease, infectious disease, and injury/violence through largescale efforts that effect change at a population or community level. This is in contrast to say, what a physician might do, which is treat an individual after they have acquired a poor health outcome (ex. treating someone for diabetes). Working at a population level and on the prevention-side allows public health professionals to prospectively address health concerns. In order to do so, public health professionals may take a systems level approach where changes have far-reaching effects (meaning, effects an entire community versus an individual) and improve long-term health outcomes; essentially, allowing you to get the most “bang for your buck”.
For example, in terms of public health work and children with disabilities lets imagine this scenario:
Children with disabilities often experience bullying at a higher prevalence than their peers. This leads to a greater rate of poor mental health outcomes. A psychologist/social worker might approach this problem by providing the best treatment approach, such as cognitive behavioral therapy for a child with disabilities who experiences bullying. A public health professional would approach this problem by first conducting research to understand the etiology of the bullying problem. Then, perhaps, they would work to develop a campaign that increases awareness in the community about bullying. Further, they would elicit change via the policy route or through systemic changes by altering protocol to ensure that educators and health care providers routinely screen for bullying. All with the intention to prevent bullying and the associated poor mental health outcomes.
However, for clarification, disability does not inherently equal poor health. Disability is not synonymous with unhealthy because an impairment does not necessarily diminish physical/mental health. Disability is largely a result of inaccessible environments and is a socially constructed phenomenon. People with disabilities do not need to be “fixed”, rather the barriers (inaccessible buildings, communication challenges, etc.) they encounter need to be addressed. These barriers can cause those with disabilities to experience health disparities, which put them at greater risk for poor health outcomes.
Formally, public health has 3 core functions: assessment, assurance, and policy development. Further, there are 10 essential services, which you can read about by following this link: https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html
I encourage you to explore the following resources to expand your understanding of what public health is, and how public health and disability are intertwined.
http://www.phi.org/focus-areas/?program=center-on-disability
https://www.who.int/news-room/fact-sheets/detail/disability-and-health
https://disabilityinpublichealth.org/
https://nationalcenterdph.org/
Victoria Eickelberg
