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Public health
Taking a population perspective on child health
  1. M BLAIR, Senior Lecturer in Paediatrics and Child Health
  1. Department of Paediatrics, Imperial College School of Medicine and Northwick Park Hospital (North West London Hospital NHS Trust), Harrow, Middlesex HA1 3UJ, UK

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  Inferior doctors treat the patient's disease Mediocre doctors treat the patient as a person Superior doctors treat the community as a wholeHuang Lee, 2600 bc

We have long recognised that many health issues affecting children and their families cannot be addressed solely by health service workers. The major health gains of the last century have been determined by changes in life quality, sanitation, and living standards affecting whole populations.1 However, for many years paediatricians working in both community and hospital systems have developed alliances with both statutory agencies (social services and education), government, and voluntary groups to plan and develop appropriate services. The child public health movement is growing in Europe, the USA, and Australia.2 ,3 In the UK, a number of initiatives have been developed, including a special joint group of the British Association of Community Child Health and the Faculty of Public Health, an advocacy committee within the Royal College of Paediatrics and Child Health, and an advocacy internet based discussion group (CHANT). Paediatricians are fully participating in the health inequalities debate, both in their contribution to the research,4 and in helping to influence wider health policy development.5

The purpose of this article is to explore the value of taking a population perspective on child health and placing paediatric care in context with the “total picture” of child health and illness. It is aimed at the general paediatrician. Other articles in the series explore whether there is a role for a specific “child public health” specialist.

In the UK, the majority of paediatric specialists work in a hospital setting, with their clinical activities usually being carried out in a ward or outpatient setting.6 The service provided is one of a secondary care service, with referrals being made by local general practitioners …

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