This book gives voice and order to concerns that the public health community has hitherto inadequately expressed. It successfully manages to highlight the many and varied problems that contemporary public health faces in a globalizing world while providing optimism for the future and an inspiring call for action. It makes the point that there is a large and changing public health agenda and we must move to address it. We have long known that health practitioners must concern themselves with the broader determinants of health. This book highlights the need for these determinants to be addressed not just at local and national levels but regionally and globally and for public health to refocus on the global trade, environment and development agendas as future health will increasingly depend on these factors.
Written in three sections the book can be read as a whole or, particularly the second section, dipped in and out of. The first section outlines the challenges facing public health and the state of health globally. The second outlines the state and structure of public health systems around the world through a series of nine chapters. Some have a regional (e.g. Eastern Europe, Africa) and others a national (e.g. the UK, Sweden, China) focus and by necessity therefore take different approaches. Yet common themes emerge, providing both despair (the endless restructuring of the public health function and reports on the need for a preventive focus as funds pour yet again into acute care) and hope (that solutions seen in one place might be applied elsewhere). Finally, the third section examines some relatively new and expanding themes in public healthterrorism, public health ethics, and the role of the public. There are some stimulating arguments, for example that bioterrorism:
provides a compelling example of why those concerned with the public's health must rediscover their passion for radical engagement with international affairs, if broad public health goals are to be achieved.
The final chapter draws the book together, examining where we go from here.
I would recommend this eminently readable and enjoyable book to all public health students and practitioners, particularly those involved in training and teaching or developing new public health systems or structures. One can only hope it will also reach a broader audience whose agenda, as the book highlights, overlaps with and influences public health. If other readers find the book as inspiring as I did, it will have achieved great things.