The Role of Public Health: A Comprehensive Approach to Disease Prevention and Health Equity

AJK and its role in improving the well-being of communities. Public health is the foundation of a strong society, focusing on disease prevention, health promotion, and creating awareness about safe practices. In AJK, public health programs aim to ensure better access to healthcare facilities, vaccination drives, maternal and child health services, clean water, and sanitation improvements. Public Health AJK initiatives also emphasize training healthcare workers, strengthening health systems, and educating communities about nutrition and hygiene. By addressing both preventive and curative measures, these efforts help reduce disease burdens and improve the overall quality of life. With increasing challenges such as pandemics, malnutrition, and environmental health concerns, Public Health AJK continues to play a vital role in protecting families and building healthier futures for the region.

The Role of Public Health

A Comprehensive Approach to Disease Prevention and Health Equity

Public health is a multifaceted discipline aimed at preventing diseases, prolonging life, and promoting the physical and mental well-being of populations. A key principle of public health is the fair distribution and efficient use of available resources to ensure that all individuals have equal access to health-promoting services and environments. The proactive approach of public health is not only about reacting to health crises but also about taking preventive measures before individuals are placed in danger.

This concept is well illustrated in the well-known river parable, which contrasts the reactive nature of medicine with the proactive stance of public health. In the parable, medical professionals downstream are overwhelmed with saving people from drowning, having no time to address the underlying causes of the accidents. Public health, on the other hand, looks upstream, identifying and addressing the root causes of the accidents while setting up preventive measures. Moreover, public health empowers individuals by teaching them skills—such as learning how to swim—so that they can navigate health risks independently.

Public Health as a Human Right

The public health perspective is not limited to ensuring access to medical services. It encompasses the creation and maintenance of environments that promote health. In 2008, the United Nations High Commissioner for Human Rights and the World Health Organization (WHO) jointly defined the right to health, emphasizing not only access to medical care but also protection from inhumane treatment and discrimination in healthcare settings.

In 2017, the WHO released a report titled Advancing the Right to Health: The Vital Role of Law, which explored practical ways to implement the right to health. The report highlighted the importance of addressing malnutrition and promoting healthier food choices. However, many of the recommendations focused on behavioral interventions, such as making unhealthy foods more expensive or restricting their availability. While these measures target individual behavior, they fall short in addressing the deeper structural causes of food insecurity and the stigmatization of marginalized groups, such as people living with obesity.

Darwin’s Law of Prevention and Public Health

In the 1990s, health researchers Hagen Kühn and Rolf Rosenbrock developed what they called "Darwin’s Prevention Law," which outlined a hierarchy of health policy interventions. At the top of this hierarchy are biomedical interventions, followed by individual behavior changes, and lastly, structural reforms aimed at addressing the social determinants of health. While structural reforms—such as improving workplace safety, providing universal healthcare, and reducing poverty—are the most effective in improving population health, they often face significant political resistance.

The relevance of Darwin’s Prevention Law is evident in the way health policy addresses issues like high body weight. Downstream interventions, such as bariatric surgery and genetic research, represent high-cost, high-tech solutions to the "obesity problem." Meanwhile, upstream efforts by public health institutions focus on encouraging healthier behaviors to prevent further weight gain. However, these behavioral prevention strategies often neglect the social inequalities that contribute to poor nutrition and fail to address the broader context of discrimination in healthcare.

Toward an Inclusive Public Health Approach

To combat growing social and health inequalities, public health must position itself as a force for social justice. It must not only advocate for behavioral changes but also push for policies that reduce inequality and protect against discrimination and inhumane treatment. As Bittlingmeyer argues, public health can only succeed as the spearhead of a new social movement if it reflects on its practices and develops a concept of health that embraces diversity and rejects standardization.

An inclusive public health system must challenge its own assumptions and work toward a vision of health that accommodates physical diversity, ensuring that all individuals—regardless of their background or body type—are afforded the same opportunities to lead healthy, fulfilling lives.

Keywords: Public health, disease prevention, screening-in-public-health, Cause & Effec in Epidemiology