Chapter 3: Social Determinants of Health
Katie Baker
The Centers for Disease Control and prevention Foundation (CDCF) defines public health as “the science of protecting and improving the health of people and their communities” (What Is Public Health?, n.d.). When you think of Public Health, you may consider mobile units that screen for breast cancer, hearing screenings in local elementary schools, vaccination initiatives, or county and state health departments that support local doctors in preventative care and the promotion of health through community outreach. These, and many more programs, fall under the umbrella of public health and prevention.
In the 19th century, local public health agencies were created in the U.S. and given the task of addressing communicable diseases. Since then, public health has addressed workplace safety, environmental exposures, health education and access to clinical care (What Is Public Health?, n.d.). The history of public health is one of heartbreak and triumph as agencies have fought to provide clean water and air, immunizations and contraceptive access for individuals and families in our country.
Public health-funded immunization drives helped to provide and encourage polio vaccination in the 1950s by providing immunization clinics in public school gymnasiums, addressing a deadly virus that could be transmitted via contaminated food and water. Prior to the creation of the vaccine by Dr. Jonas Salk, the polio virus killed or paralyzed over 500,000 people annually (WHO, n.d.).
During the recent COVID-19 pandemic, public health took center stage as government funding provided for public testing, providing masks and at home tests, research into vaccine programs and support for families whose children were no longer in school in the form of free meals. COVID’s effects shone a spotlight on how intertwined the world’s physical and financial health is as well as showing how integral public health is to a functioning society.
In addition to undertaking these projects, public health organizations were also integral in addressing the disparities seen between urban and rural health. Rural areas tend to have populations who live with higher risk of COVID-19. For example, individuals in these areas tend to be older and of lower socioeconomic status, and to lack access to quality healthcare (Melvin et al., 2020).
Funding for Public Health Programs
Public health is funded through local, state and federal funds, as well as through revenue streams, such as the marijuana tax in Washington State that pays for Medicaid, as well as substance abuse education and treatment programs. Private grant money is also an important source of Public Health funding.
In Washington state, the state Department of Health system is divided into 35 public health districts and local health departments to serve its 39 counties. Other states may divide public healthcare by city or county. In addition, many public partners, such as universities, collabor