Putting the public (back) into public health: leadership, evidence and action

Abstract

There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.

Family-Centered Health Promotion: Perspectives for Engaging Families and Achieving Better Health Outcomes

“…3 Throughout the discipline of public health, we are seeing an increasing call to emphasize empowerment of the "public" in public health. 4,5 Public Health 3.0 supports this emphasis and suggests that "public health is what we do together as a society to ensure the conditions in which everyone can be healthy." 1 These efforts call for greater public engagement in prevention and local decision-making designed to give individuals increased control over the conditions that determine health including those directly involving family relationships.…”

Ampliando vozes sobre violência obstétrica: recomendações de advocacy para enfermeira(o) obstetra

“…Dessa forma, os resultados indicam a relevância de se assessorarem os grupos existentes para criação de mecanismos de defesa dos direitos das mulheres pautados no monitoramento local/estadual da implementação do PHPN e sobre os casos denunciados de violência obstétrica, assim como promover o amplo debate sobre direitos obstétricos, negligência no cuidado obstétrico ou violações do PHPN. Necessário ainda observar que, a implantação de políticas internacionais reforçando direitos humanos universais, das mulheres e da criança, guiam a melhora da qualidade de vida dos indivíduos e das comunidades 53 .…”

What are the elements of a whole system approach to community-centred public health? A qualitative study with public health leaders in England’s local authority areas

“…It sought to build on the principles of community-centred approaches (box 1) by understanding how the public health system could become more community-centred and enable community connectedness and empowerment to be central to its role and functions. 22 The objectives were: 1. To collate learning from local areas currently demonstrating leadership and best practice in reducing health inequalities through community-centred public health.…”

“…It sought to build on the principles of community-centred approaches ( box 1 ) by understanding how the public health system could become more community-centred and enable community connectedness and empowerment to be central to its role and functions. 22 …”

“…PHE’s Healthy Communities Team is seeking to build on this work, moving beyond commissioning community-centred approaches, to putting communities and community empowerment at the heart of all public health policy and practice and understanding how this can be scaled to a level that impacts on health inequalities. 22 This is an ambition shared outside of England, 19 such as in the community-centred health model advocated and scaled by the Prevention Institute in USA that recognises that community conditions are critical to health and community prevention strategies which foster health equity lead to lasting change. 23 While England lacks similar scaled community-centred models, health-in-all-policies 24 and place-based-working 25 are other systems approaches that align to a community-centred approach and offer impact at scale.…”