The Lancet
Jan 09, 2010  Volume 375  Number 9709  Pages 93 – 170
http://www.thelancet.com/journals/lancet/issue/current

Perspectives
The art of public health: pneumococcal vaccine coverage in Mexico
Norman Daniels, Atanacio Valencia-Mendoza, Adriane Gelpi, Mauricio Hernandez Avila, Stefano Bertozzi

If the art of medicine involves making hard choices about how to improve individual health using evidence but facing uncertainty, then the art of public health involves making hard choices about improving population health and distributing it fairly under conditions of limited evidence, uncertainty, social and political constraints, and professional incentives that may be in conflict with fairly maximising population health. To illustrate the kind of public health choices a health minister faces, we focus on a current controversy in Mexico.