Public health overview

NHS Health Scotland is Scotland’s national health improvement agency and one of the country’s main national public health bodies. 

Public health in Scotland is changing. Here you can find out what public health is, how it’s changing and our involvement in this.

What is public health?

The Faculty of Public Health defines public health as ‘the science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society’.

Health, in this context, does not just mean the absence of disease. In public health, we define health very broadly as a resource for everyday life. This includes physical, mental, and social wellbeing and resilience.

We take a population focus, working to understand and influence what makes communities, regions, and countries more or less healthy. These factors that impact on health are known as the determinants of health.

Among the most powerful of these determinants of health are the forces that shape the conditions in which we are born, grow, live, work and age. These forces include

  • political
  • cultural
  • commercial
  • environmental.

To act on the determinants of health and health inequalities, public health agencies like us work at the local, national, and global levels. We take a long-term perspective since the health of future generations depends on the social, built, and natural environment we create for them now.

We also work to understand and mitigate the negative health consequences of historic inequalities and the illnesses this causes.

Domains of public health

The main domains of public health are

  • health improvement - enabling people and communities to improve their health and wellbeing by addressing the wider determinants of health
  • health protection - preventing and responding to contagious or infectious diseases and environmental hazards, and promoting resilience to future risks
  • health and care services - maximising the quality of health and care services for the population.

Each of these domains is based on the collection, analysis, and interpretation of data and research evidence. This is known as public health intelligence.

Public health workforce

A wide variety of people in different professions work together on public health in Scotland. This includes people who have public health as part of their job description, such as Directors of Public Health in health boards. It also includes the wider workforce, such as people in the third sector, who work with people and communities to promote health and wellbeing and tackle barriers to the right to health.

The Public Health Skills and Knowledge Framework (external site) describes the areas in which the public health workforce operates. It also provides a benchmark for employers to understand the skills and competencies they need.

We hosted an event in March 2017 to explore what the framework means for Scotland, which you can read about in the event report.

Public Health Review 

Scotland’s health is improving, but we continue to face significant public health challenges. There is widespread agreement that we need to change the way we do public health in Scotland to meet these challenges.

The Scottish Government established an expert Public Health Review group in 2015 to explore the issues. The report of the review highlighted the need for 

  • more clarity on organisational roles
  • stronger leadership around public health
  • a public health strategy for Scotland with clear priorities
  • greater partnership work across all sectors.