This condensed guide describes how public health works at three levels—downstream, midstream, and upstream—to improve everyone’s chance for good health. It provides definitions, examples and strategies to help practitioners and decision makers think about, and work with, the upstream determinants of health.
The four public health roles is a framework that can help organizations make health equity a strategic focus of their governance, policies, and partnerships.
Research indicates that interventions designed to close the gap between the most and least healthy can unwittingly result in a wider gap. This resource is a condensed guide to the differences, strengths and challenges of targeted, proportionate and universal approaches to improving health equity.