Levels of Public Health


Address correspondence to: Judith Baigis Smith, Ph.D., R.N., School of Nursing, University of Pennsylvania, 420 Service Dr/S2, Philadelphia, PA 19104. Telephone (215) 898-4730.


To ensure the equitable delivery of health care, there must be clear conceptions of (1) the goals to be achieved by this care, (2) the sufficient extent of improvement, and (3) the level of health to which the care is to raise the individual or the community. Yet there is no consensus on either the meaning of helath or the degree of health for which we should aim. This article clarifies the concept of health by means of a discussion of four models of health that provides directive aims for public health practice, each with its own orientaion. In addition, the options for defining an adequate minimal level of public health are analyzed. This is an especially important issue, since resources for public health work are limited. Finally, a principle of fair allocation for public health resorces is suggested.