1.4: Population and Community Health

When a person goes to their doctor’s office, the physician’s primary goal is to diagnose and treat the individual. By contrast, public health focuses on population health or community health (Centers for Disease Control and Prevention (CDC), 2014). While population and community are often used interchangeably in public health, they can also mean different things. A population is often used to describe a group that is larger and more defined by shared characteristics, such as age, sex, occupation, or geographic location. For example, a public health worker might be concerned about trends in poor maternal and infant health outcomes - thus the population they are focusing on is those who are pregnant or who have recently given birth and infants under age 1. Population health is concerned about identifying the distribution of diseases and the risk factors associated with them across and between different populations. A community is more often describing a geographically smaller group, like a town or neighborhood. Someone working in community health might focus their efforts on providing HIV tests to unhoused people in a specific area. Community health is seen as more of a “grass-roots” effort that takes into account the community culture and perceptions (Community and Population Health, n.d.). Both population and community health are important for public health efforts at the county, state, national and global levels. Public health also tends to focus more heavily on prevention of poor health outcomes rather than treatment of diseases or illnesses that already exist like the medical model does (Schneider, 2020, p. 5).

Because public health tends to focus on preventative actions and works at so many different levels, public health successes often go unnoticed or taken for granted. Take just one example: the success of flouridation of public drinking water at improving dental health. Flouride is a naturally occuring mineral that is found in drinking water around the world, but was added to drinking water in America after studies in the 1940's demonstrated its efficacy at protecting tooth enamel. Around 2/3 of Americans are served by municipal water sources that flouridate the drinking water pumped into homes, schools, and workplaces. Flouride is added at the recommended amount of 0.7 parts per million, and epidemiological studies have found that this practice has reduced dental caries (cavities and tooth decay) significantly since the 1960s. Those who benefit the most tend to be people living in poverty and children, who may not have access to regular dental care (HHS, 2015, Public Health On Call - John’s Hopkins Bloomberg School of Public Health, 2024). Yet many people may not recognize the protection of flouridated drinking water because they and their families don't have a high number of cavities and haven't lost teeth.