Public health is everyone's business. In 1948, the World Health Organization (WHO) suggested that public health is ‘an organised activity of society to promote, protect, improve and—when necessary—restore the health of individuals, specified groups, or the entire population. It is a combination of sciences, skills and values that function through collective societal activities and involve programmes, services and institutions aimed at protecting and improving the health of all people’ (WHO, 2021).
Public health is understood as both a social and political strategy; it is aimed at enhancing health, extending life and improving quality of life across entire populations through health promotion, disease prevention and a range of evidence-based health interventions. The Ottawa Charter, a key framework, presents a transformative perspective on identifying and addressing the determinants of health and solving public health issues (WHO, 1986). This framework emphasises a holistic approach to health promotion with a focus on broad strategies that shape public health practices.
Since its introduction by the WHO nearly 4 decades ago, the Ottawa Charter has been pivotal in reshaping public health approaches, highlighting shifts in how we understand and tackle health determinants and public health challenges. The Charter outlines five key strategies for health promotion:
These strategies have served as a foundational guide for public health initiatives and continue to do so, evolving into concepts such as Health in All Policies (WHO, Finland Ministry of Social Affairs and Health, 2014). Inextricably linked to advocacy, empowerment and collaboration, the Ottawa Charter's strategies remain essential and adaptable, offering a relevant framework for contemporary health promotion and public health efforts.
The evolving role of the advanced practitioner (AP) places these skilled professionals in a unique position to influence public health on multiple levels. As clinical leaders equipped with specialised and extended education, APs work to address health disparities, lead preventive initiatives and advocate for systemic change in healthcare. The reach of APs extends far beyond the traditional clinical environment into community settings, where they advocate for health equity and wellness, while also informing the development, implementation and evaluation of public health policies. In their expanded role, APs are educators, policy influencers and researchers, making their contribution in profound and transformative ways.
The integration of advanced clinical practice with public health priorities provides APs with opportunities to engage in proactive rather than reactive healthcare, recognising health trends that may indicate broader issues affecting the diverse communities they serve. By identifying patterns in chronic diseases, mental health conditions or contagion events, APs can act on behalf of entire populations, rather than solely focusing on individual patients.
In addition to disease-specific interventions, APs play a crucial role in addressing environmental and societal health factors and are well versed in evaluating social determinants of health, which often lie at the root of health disparities. With this holistic approach, APs can work collaboratively with public health officials, community organisations and policymakers to tackle these issues through comprehensive, community-centred initiatives.
At the core of public health is the imperative to reduce health inequities. APs address these disparities directly through patient care and indirectly through public health initiatives. In communities with limited healthcare access, APs frequently serve as the most accessible or available healthcare provider. Their role as primary health advocates within these settings allows them to ensure that marginalised populations are in receipt of culturally competent and high-quality care. In many cases, APs have become trusted members of the community, fostering relationships enabling them to provide culturally-sensitive care. This trust is critical to bridging the gap between healthcare systems and communities that may be hesitant or unable to access traditional services. By understanding and respecting cultural beliefs, socioeconomic challenges and historical experiences with healthcare systems, APs can provide care that addresses medical needs and resonates with the community on a personal level.
In community health settings, APs lead on initiatives that target specific health concerns, such as obesity, smoking cessation, mental health and substance abuse. While these outreach efforts address current health crises, they also help prevent the emergence of future public health issues. By designing and implementing evidence-based interventions, APs are creating lasting impressions that contribute to a healthier, more resilient society. APs' clinical insight and practical experience adds valuable perspectives to policy debates. By participating in policy discussions, APs have the opportunity to influence healthcare systems and shape policies that are better aligned with real-world health needs.
In their role as advocates, APs can address crucial issues such as mental health services, maternal and child health, environmental health and access to affordable healthcare. The AP advocacy work encompasses collaboration with public health officials, legislators and community leaders ensuring that healthcare policies address the needs of all individuals, especially the most vulnerable. In undertaking and facilitating research on topics such as health disparities, chronic disease management, mental health and preventive care, APs provide valuable insights. Research led by APs has the real potential to be translated into direct clinical application, improving the quality of care delivered and supporting initiatives that address public health challenges.
The call to action for APs is clear: continue to embrace the responsibility of leading public health initiatives, address health disparities, advocate for policy change and drive research efforts that contribute to healthier communities. Public health is indeed everyone's business and through collaborative, community-centred approaches, APs can make profound contributions to improving the health and wellbeing of populations worldwide. By recognising their vital role in public health, APs can help shape a future where equitable healthcare access and improved health outcomes are a reality for all.
By leveraging their expertise, compassion and commitment to public health, APs will continue to shape a future where healthcare is accessible, equitable and prevention focused. Their role in public health exemplifies the duty that all healthcare professionals have to transform individual patient care into community-wide wellness initiatives, creating enduring impacts that have real meaning across generations.