What is Public Health and why is it so important?

Welcome to the first in a series of regular blogs on public health in Enfield Council.

What is Public Health and Why is it so important?

Our aim is simple – to help make public health everyone’s business. In achieving this we want to enable a better understanding of what public health is about and how we can all work together through all that we do to improve the lives of our residents, prevent what is preventable and reduce the gap in inequality.

2018 marks the anniversary of several important health related events. It is 170 years since the first Public Health Act (1848); 100 years since the devastating impact of the Spanish Flu (1918); and 70 years since the founding of the NHS (1948). The common thread between them is the recognition that poor health, whether as a result of disease or living conditions, has a profound effect both on the individual and on society as a whole. Once this is accepted then we can commit to working together to prevent or minimise their impact.

We know that increasing rates of physical activity, stopping smoking, eating healthily and reducing alcohol consumption all have important parts to play in improving both physical and mental health, but we also know that a single Public Health team can’t improve these on its own.

The root causes of what influence us to have healthy or unhealthy behaviours, and consequent good or poor health outcomes, lie in a wide range of areas; from the homes we grow up in, the family supports we have, the community we live in, the education we receive, the jobs we get and the aspirations and opportunities we have. These in turn are all influenced to some degree by services and functions provided by the Council and the policies and decisions it makes.

 Health in all Policies

An approach that we believe will help achieve true population-level transformational change in behaviour is called ‘Health in All Policies’ (HiAP). It’s an approach to health that aims to harness the power and impact of all that we do as an organisation to achieve better health for all, particularly for the most vulnerable or those in greatest need.

The World Health Organization defines HiAP as, “An approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity”.

The HiAP approach can focus on specific public health issues, such as obesity or mental wellbeing or serious youth violence, and identify policies which have a major impact on them. Alternatively, it can focus on a key policy area with significant health impacts – for instance transport or housing or education – and work with relevant departments and partners to improve health outcomes.

As such, HiAP can create the potential to take action in a focused way across a range of areas that can improve health. This will have clear benefits for individuals (through improved wellbeing), employers (through reduced sickness absence), service providers (through reduced demand) and the economy at large (through a more productive workforce); i.e. HiAP seeks to find the ‘win-wins’ where all partners have a positive stake in the action and all can share in the beneficial outcomes.

I firmly believe we can achieve this for the people of Enfield. There is strong corporate commitment for embedding HiAP and, in recognition of its importance and potential benefits, it is specifically mentioned in our new Corporate Plan and resource from the Transformation team has been provided to work closely with Public Health to make this a reality over the next few years.


Our HiAP approach will be accompanied by a simple and memorable message: 3-4-50 i.e. the 3 most common unhealthy behaviours (smoking, poor diet and lack of physical activity) contribute significantly to developing the 4 most common diseases (diabetes, stroke, heart disease and cancer) that together result in over 50% of early deaths in Enfield.

Along with this, every year we produce an Annual Public Health Report which talks about our residents’ health needs and priorities, and what we are doing about them. The 2018 report has just been published and explores all the things that influence our health and how a HiAP approach can help start to address these. I hope you will take a look.

Thank you for reading and please do let us know if you want to know more or if you have any great ideas for improving our residents’ health and wellbeing through all that we do as a Council.

by Stuart Lines

Director for the Public’s Health

London Borough of Enfield