Building back better: nurses leading our approach to preventing, promoting and protecting All Our Health

As we enter 2021, the priorities for health and care systems across the globe remain centred on the need to manage the COVID-19 pandemic (Bourgeault et al, 2020). Although, of course, the unrelenting events taking place since early 2020 are things that we would not want to go through again, at the same time this has provided nurses and midwives with first-hand experience of the complex and dynamic nature of public health policy and practice.

Public health is classically described as ‘waves’ depicting the focus for health achievement (Figure 1). We are now in the ‘fifth wave’, the ‘culture of health’ where the aspiration is for people to see health as a value and interventions seek to create a culture and environment that promotes healthy behaviours above those considered to be unhealthy (Davies et al, 2014; Academy of Medical Sciences, 2016). Earlier waves from the 1830s focused on creating clean water and sanitation (structural, first wave), developing medicines and improving transport and communications (biomedical, second wave), creating evidence-based health care (clinical, third wave) and the emergence of the welfare state and universal education (social, fourth wave). As health and care professionals progressing in the fifth wave, we can learn from earlier waves and build our knowledge, understanding and resilience so that we can respond effectively to new health challenges. This means that, in the fifth wave, armed with our knowledge of the importance of clean water, immunisation, research, and evidence-based practice, we can engage and encourage people to be actively involved in their health and wellbeing. This will be essential in the coming months and years as the emergency moves into recovery and a focus on efforts to ‘build back better’.