Public health interventions focus on the health needs of the entire population or population groups. Personal health care providers have little incentive to consider population-based services, although they may provide individual clinical preventive care. Even with increased attention to the provision of clinical preventive services by managed care organizations and others, the clinical preventive services provided will often be those with short-range, immediate payoffs. Moreover, populations most at risk for increased morbidity and mortality may be least likely to receive these clinical preventive services because of financial and non-financial barriers. Public health addresses these issues through outreach, health education, transportation and translation services, and culturally sensitive provision of services. These are provided by the public health system.
Personal health care can help heal injuries, alleviate disorders, and treat many diseases, but it is public health programs that prevent the onset and spread of disease and diminish the likelihood of injury. Yet, the vast bulk of health spending in the United States is in the personal health care system; public health programs are funded by a very small and decreasing portion of health expenditures, with the result that society is not provided with all the public health services necessary to maintain the public’s health.3 If the public’s health is to be assured, the content of all activities must be altered to focus more on disease and injury reduction and on health protection and promotion-that is, on how the public health system supports the public’s health.