[Public health and citizen involvement--guidelines and general practice in Herne]

Health problems cannot be solved only by expanding medical and other systems of service. Limitations of these services are not only set by costs, but also by the disease patterns themselves. The traditional role of the patient must be redefined. It is necessary to develop personal health-coping strategies outside medical care, and for the citizen to participate in improving conditions of health in general. The public health system has the specific duty of initiating and establishing these new approaches to health promotion and coping with disease. A model for these new municipal health policies is presented with reference to medical practice in the city of Herne in the Ruhr area of Germany.