Interest in the possibility of bringing about a public health revolution in children's services is building up a head of steam in the UK – drawing on the results of good scientific trials of innovative programs in the US.

Now comes a bold attempt – and one that will certainly increase the momentum – to pull together current thinking on public health approaches with the school-age population.

In this context "public health" refers to population-wide strategies to improve the health and well-being of all children, typically demanding an ecological view of the child – one that seeks to understand the relationship between the individual and his or her living environment.

In her preface, Diane DeBell, director of the Centre for Research in Health and Social Care at Anglia Ruskin University, describes the development of a trend which began in the UK in the mid-1990s and has since been encouraged by the Children Act 2004 and the Every Child Matters agenda.

Along the way, as she rightly observes, progress has been hindered by ingrained habits of practice, a succession of service reorganizations and by UK Government anxieties about the fall-out from a large-scale redistribution of resources. (To which one might add that public health strategies are also necessarily long-term and require taking a prudent step back from the latest scare or outrage: not a characteristic of recent UK administrations.)

Diane DeBell’s contributors explore three key questions: What is the state of child well-being in the UK? Who is responsible for children's health and development? and How can a public health approach contribute to improving the situation?

They do a skillful job weaving together epidemiological studies that address a wide range of child outcomes and the influences upon them. Children's mental and physical health, school experience, lifestyles and family situations are all considered (along with the legal and political frameworks that affect them). The result is a a vivid and at times worrying portrayal of the condition of children in the UK.

A public health approach takes sound epidemiology to another level. Improving outcomes for all children requires, first, gathering and analyzing solid data on the state of children and the influences on their well-being (sometimes called “risk and protective factors”). The results are used to inform the development of services that, logically – in the sense that the reasoning is in tune with the best current science – are capable of addressing identified difficulties.

DeBell and Co’s contribution to these objectives is to advocate a strong ecological perspective that encompasses the multiple domains of a child’s life. So, for example, the home, school and community are reflected in the chapter structure of the book. Each section refers to interactions between domains: for example, the importance of linking schools and families in Full Service Extended Schools initiatives or coordinating the National Healthy Schools Programme (NHSP) with wider community activities. The clear message is that sustained change in one domain cannot occur without consideration of the others.

The answer to the second big question, "Whose responsibility is children's health and development?", is therefore, resoundingly, everybody’s.

This ought to give the book very broad appeal: it is for anyone who works in some way with the school-age population (including those in education, physical and mental health, housing, community workers, the police and criminal justice system, as well as researchers). Its central argument is that for too long children's health and development have been viewed as separate from society; improving outcomes for children – a mission whose obscure language has trapped it in a bureaucratic corner (who dares own up to that ambition over breakfast?) is the responsibility of the whole social structure.

So how might a public health approach operate in practice? Dawn Rees and Diane Morley’s chapter on child and adolescent mental health provides an illustration of the necessary shift in thinking. They suggest that “sometimes our physical health is not so good, but it does not necessarily mean that we are seriously ill”, and argue that the same simple principle can be applied to mental health.

Thus, a public health approach requires thinking less about mental illness than about mental health; and this broader view may apply as valuably to other aspects of child development. It may not sound much, but the implications are very significant. It calls for an unswerving conviction that working on behalf of children who do not display any impairment at all will in due course greatly benefit those who do.

Unfortunately, around this point the trail goes rather cold. The book struggles to offer concrete examples of what a public health approach for all children would look like in practice. Important connections between the progress of the average child (the "mean" of the statistical distribution) and the predicament of the child with significant problems (the "tail") are missed. So, in relation to Rees and Morley’s example, the book stops short of explaining how improving the mental health of children generally results in reduced mental illness.

Much of the material for that missing chapter is ready to be written. Prevention Action looks forward to an early second edition.

Public Health Practice and the School-Age Population. DeBell, D (Ed), 2007 London, Edward Arnold, 288 pages (pb) £19.99. ISBN: 978 0 340 907207