Edited by StephenGillam, JanYates and PadmanabhanBadrinath . Published by Cambridge University Press , 2007 . Paperback, 335 pages . ISBN 978-0-521-68983-0 . RRP $99
Reviewed by Karen Willis
Mother and Child Health Research, Latrobe University, Victoria
Public health policy and practice draws on a wide range of disciplines. The challenge in teaching public health is in drawing on the best of these disciplines to instil in students a critical and evidence-based approach. This text written in the UK aims to equip students with sufficient knowledge of the sciences underpinning public health (Part One – The public health toolkit) and then develop this knowledge through the application of public health knowledge to a range of issues (Part Two – The challenges of public health in practice). The text is accompanied by a CD of additional information and quizzes related to the content of each chapter.
In Part One, the authors have provided clear and, generally, accessible explanations of the language of public health knowledge, and explained the underpinnings of epidemiological, demographic and evidence knowledge bases. The book and its accompanying CD is therefore a valuable resource for public health students and practitioners. The text begins with a chapter on demography and this provides a valuable context for the following chapters on epidemiology, evidence-based health care and improving population health, before closer examination of skills required for needs assessment, evaluation, decision making and health protection. There is good use of tables and diagrams to illustrate the points being made.
In Part Two, population health issues (children, adults, the aged) are examined, along with problems of health inequalities, health policy, quality improvement and international development. Again, graphic depictions are used to illustrate the problems of various population groups. The first three chapters in this section describe these problems in depth, and invariably conclude that strategies such as lobbying and working with key stakeholders should be used to resolve the problems. There is however, very little information provided on how best to do this, and how the seemingly obvious problems presented may, in fact, be contested. In the chapter on adult health, a broad social view of health determinants is presented, but the ensuing discussion refers to statistics about the burden of disease, rather than how living and working in unhealthy social environments can also have an effect on health. While some of these issues are covered in the chapter on health inequalities, where there is good discussion about the effects of the social environment on health, this chapter sits outside the approach taken in most others. The chapters on policy and quality measurement also provide useful information about key issues that are the focus of debate about health generally, and public health, specifically.
I am not sure how students would respond to this book – Part One is quite dry and while it provides a good springboard for teaching about key public health concepts, this would need to be accompanied by inspired and passionate teaching. There is, as stated above, some good chapters in Part Two, but these are patchy (often a problem with edited collections). Graduate students should be able to engage well with the debates about health inequalities, policy and financing that are covered in Part Two. Of greater concern is what is not covered in this text. While there is (as there should be) substantial coverage of epidemiological and statistical approaches to public health, the broader holistic approaches to health promotion and community development are not covered. There is little indication of alternative ways of thinking about the constitution and resolution of the challenges faced by public health practitioners. Where this is alluded to, the authors have not really ‘drilled down’ into the implications of partnership, consultation and negotiation with the people for whom public health practices and policies are most important – the public.