The public health system is part of our health-care system

Dr. Eileen de Villa, Toronto’s public health chief, taking leave of absence for medical treatment. (Photo: Dave Bajdeca/Flickr)

‘A total-immersion response’

By Dr. Eileen de Villa

Last fall, I wrote in the Toronto Star that, while I was confident that our public health department’s staff and programs were capable of addressing the public’s health crisis, our lack of a complete response to the COVID-19 epidemic was troubling. I wrote:

“With the COVID-19 pandemic now in its second year, we can’t call attention to chronic disease and public health as a whole as the health system collapses. But we must. And Toronto has a total-immersion response that has done just that.

The health-care system is a system of social networks, and our community’s health challenges must be met by all of them. We must build up our public health system’s capacity. And, for that to happen, we need public health directors across the system that have the experience, the knowledge, and the courage to lead a public health system that is both effective and accountable.

But public health does not just mean a government’s role in the health and well-being of its citizens. Our public health system is part of our health-care system, offering the same type of health-care services, yet in a different way. The health-care system is about managing health, but public health is about changing health. It is about taking care of the most vulnerable, the sickest, the highest risks, the most socially isolated and those with the highest mortality. It is about ensuring that all our citizens are healthy. And it is about preparing people for what we know they are most likely to face in the coming months.

The challenge is to make sure those people have the resources they need. And, in the public health world, that means: to have enough people on the front lines to provide care, to be part of the network and, therefore, more able to anticipate and protect against illness.

In short, a public health system is not just about the health of

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