Unsuccessful attempts of health care system reform in Poland were carried out in the presence of new factors and threats which affect the health situation in Poland such as negative aspects of globalization, high level of unemployment, huge emigration of young and able people as well as an organizational and moral crisis in the health care. The epidemiological significance of chronic noninfectious diseases is on the rise, including rheumatic conditions which in developed countries are among the main causes of disability. Other important problems come from the fast process of population aging, rising level of social and territorial health inequalities and the low, even in comparison to the Czech Republic and Hungary, level of health care financing. The evolution of concepts and areas of public health as well as the definition of new public health were presented and discussed in the context of the above-mentioned health situation threats and determinants. The essential public health functions as defined by WHO, which should remain the responsibility of the state, were also presented. The author also discusses the selected criteria and determinants of rational and effective health policy, elements of the diagnosis of the health situation of the population as well as the significance of rheumatic diseases in the perspective of public health.