In Ontario, the Health Protection and Promotion Act (HPPA) R.S.O. 1990 provides the legislative mandate for local public health units.
The HPPA and related provincial legislation provide for the existence, structure, governance, authority and functions of public health units and medical officers of health. The HPPA also enables related regulations, the Ontario Public Health Standards (2008), associated protocols and the Ontario Public Health Organizational Standards (2011). Together these documents establish the requirements for fundamental public health programs and services and management and governance practices.
Public health is concerned with the health and well-being of the whole community rather than the treatment of illness and disability. Health is viewed as a resource for everyday living, and in turn is influenced by the everyday environment that we are part of. Studies have repeatedly shown that the broad determinants of health such as level of income, social status, education, employment opportunities, work place environment, physical environment, and family/friend supports have as much or more to do about influencing health than does the presence of health care practitioners and facilities. This is not to say health care is not important; rather it is intended to make the point that the availability of health care is only one piece of having good health.
Public health focuses on three areas:
- Protecting the public from conditions that may put health at risk. This includes work in the areas of food and water safety, environmental risks such as toxic waste handling and air pollution, second-hand smoke, public sanitation, the spread of rabies and vaccinations against major communicable diseases.
- Preventing future disease and injuries.
This includes falls prevention programs for seniors, car seat safety programs, and screening programs (such as dental and infant hearing) where early detection of illness can lead to significant improvements in health.
- Promoting health by changing people’s knowledge, attitudes and practices about health-related behaviours and supports.
This includes providing education and support for healthy behaviour change around tobacco use, nutrition, physical activity, birth control and reproductive health, breastfeeding and prevention of sexually transmitted infections.
Public health delivers its programs and services on a population health approach. This means that programs are targeted at either the public as a whole (e.g. physical activity, dangers of second-hand smoke) or sub-groups of the population such as expectant mothers (pre-natal health), high school students (drinking and driving), or women over 50 years of age (injury prevention). Public health practitioners also aim to influence politicians and policy writers at all levels, to consider the health implications of proposed policies.
The work of public health complements the work of much of the health care system, which focuses mainly on the treatment of individual illness and disability.