[Public health in the design of population-based prevention programs in the health system. SESPAS report 2010].

Health systems have been redirected toward effective and equitable health policies. Community health and population-based prevention programs with adequate quality assurance systems play a key role in this process. In the Spanish national health system, these programs involve both public health services and clinical care and contribute to their coordination. Population-based prevention consists of collective action to protect health, such as public health measures, on the government's initiative, and is aimed at the population regardless of the insurance system. These preventive interventions should only be implemented when measurable criteria of efficiency and equity can be met, with an appropriate balance between benefits and harms to avoid iatrogenic effects in the healthy population. In population-based programs, public health services can promote policies involving intersectoral collaboration on health services, with specific interventions on groups through community participation. Population-based preventive actions always require coordination and consequently mobilization of all the mechanisms between public health and health care is required to provide all the entities involved with the information needed to perform their tasks: overseeing interventions by both hierarchical structures, feedback, standardization of work processes and skills through programs, and mutual adjustment through integrated information systems and liaison tools. Population-based prevention helps to integrate the health system, acts as a cohesive factor among regional health services, and demonstrates that a community perspective is feasible in Spain.