Evaluating and rethinking public health for the 21st century: Toward vulnerable population interventions [opinion].

Chatelan, Angeline; Khalatbari-Soltani, Saman (2022). Evaluating and rethinking public health for the 21st century: Toward vulnerable population interventions [opinion]. Frontiers in Public Health, 10, p. 1033270. Frontiers Research Foundation 10.3389/fpubh.2022.1033270

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Public health preventive interventions aim to improve population health through
two main approaches. Firstly, individual-centered interventions seek to change knowledge and behaviors of individuals identified as at high risk of disease. Secondly, population-centered interventions are delivered across the whole population, without prior detection of individuals at increased risk of disease (1). Population-centered interventions can address three types of health determinants: (i) the personal behaviors (e.g., mass media campaigns to improve diet), (ii) the physical environment (e.g., clean air and water policies), and (iii) the social and economic environment (e.g., safe housing provision). Despite the significant role of both individual- and populationcentered approaches in improving population health during the last decades, health inequities between socially, culturally, or financially disadvantaged groups within populations are increasing, at least for some health outcomes (2). This is partly due to shortcomings of both individual- and population-centered approaches. Learning from modern public health history and given the health emergencies such as the COVID-19 pandemic, this commentary argues that 21st-century public health should mainly invest in vulnerable population interventions. This approach aims to decrease health inequities between socially defined groups and is a necessary complement to population-centered interventions.

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