Abstract
Public health can play a pivotal role between the health care system and the whole of society when it comes to designing—and also to implement them—health care policies and, above all, general public policies with impact on health. Policies which require the involvement of many other sectors besides the health sector, since many of the determinants of health, beyond the absence of disease, are unrelated to the health sector. Prioritization often involves competition between the more traditional perspectives of health that are based on a pathogenic approach and aim to cure and prevent disease and the salutogenic approach that aims to detect and promote the causes of good health or at least of resilience. The absence of one satisfactory theory of health is a limitation of the salutogenic perspective but we don’t have either a true theory of the disease, beyond the description of pathological entities. Public health, understood as what we do as a society—not just as a health system—to guarantee the health of people has the responsibility and the opportunity to combine both perspectives in a balanced way.
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Notes
- 1.
The disability-adjusted life year (or DALY) is an indicator of the burden of disease. It was originally designed by Harvard University for the World Bank and adopted by the WHO in 2000. It takes into account an older indicator, potential years of life lost (due to premature death) but only those that would be lived in good health, so that mortality and morbidity are measured at the same time by means of a single and comparable indicator. A DALY is equal to a lost year of healthy life. Suitable for measuring the impact of chronic diseases, it weighs the importance of low mortality diseases such as mental and neurological ones.
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Segura-Benedicto, A. (2019). Diseases, Problems or Needs: A Framework for Public Health. In: Vallverdú, J., Puyol, A., Estany, A. (eds) Philosophical and Methodological Debates in Public Health. Springer, Cham. https://doi.org/10.1007/978-3-030-28626-2_2
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