Public Health Sciences: Challenges and Opportunities

Report of the Public Health Sciences Working Group convened by the Wellcome Trust

The terms of reference of the Public Health Sciences Working Group convened by the Wellcome Trust were to consider the current state of the public health sciences in the UK and make recommendations on measures that would enhance their impact upon the public health. The Group was concerned with the public health sciences and how they relate to public health practice in the inter-related areas of health services, health protection and health improvement.

Impressive achievements in the biomedical sciences and medical care can obscure the fact that the circumstances in which people live, whether these circumstances are under their personal control or not, are still the major determinants of health.

The need to place far greater emphasis in healthcare on the prevention of illness and the promotion of good health rather than focusing predominantly on treating ill-health has been starkly highlighted by the Wanless report of February 2004, and the Government is to publish a White Paper on Public Health in the summer.

Given the enormously increased expectations of public health, greater investment in the public health sciences is now crucial if this opportunity is not to be missed.

Public health policy and practice has to be underpinned by academic research through measures to design, conduct and evaluate public health interventions to improve public health in the UK in the most beneficial and cost-effective way.

The report highlights the extraordinary disparity between, on the one hand, the overriding importance of the public health sciences for public protection, service provision and health improvement and, on the other, the limited strategic interest that is taken in their infrastructure and conduct.

Conclusions

The Working Group concluded that a concerted programme was needed to bring together three basic components:

routine and other research data that provide the basis for understanding the causes of disease, the determinants of population ill-health and the benefits of treatments and health improvement programmes
people competent and entitled to generate, manage, access and interpret such data
a framework for implementing the outcome of public health sciences research through policy implementation.

Recommendations

The Working Group recommends:

establishing a top-level funders' group to develop a strategy for securing the future of public health research
identifying the regulatory barriers that may hamper this type of work
investing in the long-term in the academic infrastructure at undergraduate, postgraduate, research fellow, lecturer and professorial levels
establishing Public Health Centres to bring together the different scientific disciplines needed to address public health issues
developing a more informed dialogue between scientists, the public and the media to convey a better understanding of health risks
developing policy based on evidence and not on assumptions.

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