According to Naidoo and Wills (2000) public health is characterised by several factors - a concern for the health of the whole population (whether a geographical population, a client group such as gay men, or a group of people experiencing a specific health problem, such as Chlamydia); a concern for the prevention of illness and disease; and, lastly, a recognition of the many social factors that contribute to health. There are a number of strands to public health:
• Health protection, enabling people to live in a clean, safe environment, or preventing them from contracting diseases by, for example, implementing a needle exchange programme.
• Health promotion, tackling some of the determinants of health such as poverty and unemployment, or implementing specific programmes such as safer sex campaigns. Addressing the issues of poverty and unemployment can be regarded as a structural approach to health promotion through changing the fabric of society; whereas safer sex programmes encompass a behavioural approach, whereby individuals and groups are encouraged to take control of their lives and determine the actions they take.
• Health maintenance, that is, maintaining or preventing further deterioration in health by operationalising screening programmes to identify the early onset of disease - for example cervical screening programmes.
As Naidoo and Wills (2000) point out, public health and health promotion share many principles and strategies. Public health encompasses strands of health protection, health promotion, health maintenance and the provision of health, social and voluntary services to improve population health. Health promotion is the translation of these strategies into practice and raising the awareness of these issues. For example, a public health strategy might be the reduction of teenage pregnancy rates while the health promotion aspect of this strategy might be the development of leaflets for teenagers containing information about safer sex and contraception, the delivery of sex education programmes in schools, and/or a family planning nurse discussing sexual health with teenage clients on a one-to-one basis.
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