•Public health is population-based
•Medicine is based on the individual
•Medicine tries to maximize the chance of the best outcome for the individual.
•Public Health tries maximize the best outcome for populations.
•Given limited resources, PH cannot address every risk.
•PH must focus on areas considered most important and/or where resources might have maximum impact (e., prevent most damage).
•EXAMPLE: Rabies affects few people, but creates fear and is very fatal (worst outcome); prevention maximizes impact.
•EXAMPLE: Clean water affects the entire population (“an ounce of prevention is worth a pound of cure”)
•While medicine also addresses prevention, Public Health balances what individuals might prefer to do if left unchecked and actions that appear necessary for the good of the whole group.
•PH practice is always struggling to find the correct balance between respect for individual autonomy and decision-making and the need for limitations on individuals in order to achieve social justice. This is the heart of the community decision-making that is necessary for promotion of the public’s health.
•EXAMPLE: The establishment of environmental regulations.
•EXAMPLE: Immunization requirements of all children.
•EXAMPLE: The move to limit or eliminate use of tobacco products.
•EXAMPLE: The HIV epidemic exemplifies this tension
•Syringe and needle exchange.Access to substance abuse treatment.
•Tools of Medicine (used to diagnose and treat diseases)
•Tools of public health (allows practitioners to look at long and short-term trends across populations)
Epidemiology is the one science unique to public health.