american journal of public health

american journal of public health

The Importance of Public Health in America

1. Introduction

To gain an understanding of how public health affects society, an exploration of the ecological model is useful. The ecological model states that it is helpful to consider the “ecosystems” in which people live and work and to see how they affect people’s health. This can also be seen as a “web” or a “nest” in which people reside. The model largely influenced the direction of Healthy People 2000, which was a new approach to public health in the US, aiming to increase the quality and years of healthy life and to eliminate health disparities. Healthy People 2000 also spawned the development of the HP 2010, which is the current initiative in the US. This took a different approach to looking at public health, in the fact that it attempted to identify public health issues that were the most pressing in society and how these could be eliminated or improved. Both HP 2000 and 2010 fit in with the ecological model, as they can be seen as trying to identify factors that affect society and how these can be altered to benefit the health of society. This is an important factor of public health in the US: identifying the issues the public currently faces and targeting these with improvements in the quality of life. By singling out these issues and seeing how they affect society, it is possible to implement changes to these factors and monitor these changes to see if there has been an improvement in the overall health of society.

When considering the definition of public health, there are many alternative definitions, although the majority fall into the categories of “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society” and “the combination of sciences, skills, and beliefs that are utilized to ensure the conditions that cause health for people”. Public health in the US has evolved through many stages, although the main driving force behind the improvements was to better the overall health of society. This can be seen through various historical events public health was involved in, such as the Sanitation Movement, and various Acts, such as the Housing and Development Act and the Health Services and Facilities Act. These Acts were successful in getting public health involved in many of the other sectors. Although public health efforts had slowed through the mid-20th century, it has regained significant interest, prompting the Institute of Medicine to prepare a full assessment of the nation’s public health in the 21st century.

Public health is an important issue in today’s society and is perhaps more important now than ever. It touches the lives of Americans in more ways than they realize, whether it be coming into contact with an anti-tobacco advertisement, drinking a glass of tap water, or seeing the price of a pack of cigarettes. Public health is important in all sectors of society, whether it be the private sector, the public sector, or even individuals’ personal health. This paper will explore the progression of public health throughout history, focusing on the US, how it affects society, and the current public health issues that one faces today. There will also be a discussion of how public health has affected globalization. By understanding the history of public health in the US, some of the current public health issues, and how it affects the overall health of society, we can begin to understand the relevance of public health today.

2. Current Public Health Challenges

Some current public health challenges involve state and national funding. Public health funds in the past were primarily focused on infectious disease control, environmental health, and emergency preparedness and response. However, the recent concern over bioterrorism preparedness is threatening the diversion of public health funds to support this effort. This was identified as a significant issue during the anthrax incidents. While the consequences of these actions for redirecting public health funds are unclear, it is likely to impede current public health efforts and have adverse effects on future prevention of both acute and chronic health issues. An associated issue is the formation of preparedness for the occurrence of a public health emergency such as a natural disaster or act of bioterrorism. While it is essential for the public health community to respond to such events, the delegation of resources towards this preparedness might have drastic implications for allocation of funds to existing chronic health issues which constitute major health problems in the United States. Another major challenge is the ability to effectively respond to health needs of migrants, internally displaced persons, and refugees. Dire health issues in countries from which these persons have come combined with stresses of migration often result in a worsening of health. This group is also at increased risk of multiple health problems in their new country of residence. These issues pose a significant challenge for public health which is used to dealing with defined populations. The recent crises involving natural disasters and war and terrorism in many parts of the world have further increased the number of such persons and the challenge for public health. The effect of globalization on the spread of infectious diseases is another current issue. This increasing interconnectedness of the world is leading to the spread of known diseases to new areas but also allows increased ease for the spread of new and reemerging diseases. 20 years since the eradication of smallpox, there are still only two diseases that have been successfully eradicated, and diseases such as polio, malaria, and TB still pose a significant threat to the world. Globalization also adds a new level of complexity to the immigration of vectors and animal hosts for various diseases.

3. Strategies for Improving Public Health

In high-income countries, health policies have now shifted towards addressing the challenge of managing long-term conditions. A common policy tool is to encourage self-care among people with chronic illness to improve their health and reduce the demand on acute health services. This may involve expert patients’ programmes to help people acquire the skills to manage their illness more effectively, or various forms of direct or indirect incentives to adopt healthier lifestyles. Other policies aim to improve the coordination of care for people with chronic illness and to increase the quality and effectiveness of primary care as a substitute for hospital or specialist services.

One common approach to improve health is to focus on the health condition of a population. Public health strategy has a long tradition of giving priority to improvement of the health of the population and reducing health inequalities between population groups. Various forms of structural measures to improve the health of the most disadvantaged social groups have been implemented ranging from health-related components of social policy through health improvement programmes in target groups to policies to affect the broader social, economic, and environmental determinants of health.

4. Promoting Health Equity

It should also be recognized that there are many immigrants whose poor living and working conditions, along with constant discrimination, have increased their rates of mental disorders. These are just a few of the many examples that there are in regards to the social determinants of health and the implications of health equity.

An example can be race and ethnicity, where unfair and avoidable inequalities in health status are often viewed as being a direct result of race or ethnicity. In today’s society, racial and ethnic minorities are often receiving differential treatment in regards to their access to quality healthcare. This differential treatment can only be changed by addressing the prejudiced attitudes of healthcare workers, often a result of stereotyping and being taught to avoid different ethnic groups. These attitudes have conclusions race-based mal-distributions in quality of medical treatment and increased rates in chronic health conditions.

These disparities are often the result of avoidance of social determinants of health, which are the complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social determinants of health include factors like socioeconomic status, race, ethnicity, physical environment, etc. It is evident that these factors are often the cause of impeding certain groups from achieving health equity.

Health equity is the attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities. It is necessary to first understand the implications of why certain groups are impeded from achieving the same opportunities for health and healthcare, which often lead to the unfavorable outcomes of health disparities.

By our nation’s Constitution, it states that “all men are created equal” with “certain unalienable rights, that among these are life, liberty, and the pursuit of happiness.” These are the same rights that health provides to everyone, giving them the opportunity to live life to the fullest, without impediment and with the ability to pursue their dreams to the best of their ability.

5. Conclusion: Building a Healthier Nation

The United States of America has been one of the most powerful advocates of public health in today’s modern world. It has contributed greatly to the technical and scientific knowledge of public health and has provided many of the essential tools needed to improve on public health in the form of technology, funding, and infrastructure. However, it has been argued that the USA has failed to recognize the full potential of public health; where so far it has only been used as a tool to prevent disease and not as a means to advance the health of the population as a whole. This is something that needs to be addressed as public health evolves into an even more global and political issue with the ever-increasing diversity of people and cultures, and the effects that globalization has on the spread of disease in and between different societies.

The importance of private and personal health of a nation, in terms of health status, longevity, and future health costs, has been well established. A healthier population will result in lower healthcare costs in the long term, and these extramural costs are something that governments simply cannot afford in the future. There are also the potential economic gains of investing in public health, such as reducing the burden of disease and disability in the population, which can lead to increased productivity and economic growth. This has been shown through various economic studies when countries have invested in public health, from increased childhood vaccination programs to smoking cessation programs, to increase the health of the population. It should therefore not be viewed as a burden on government spending but as an investment in the future of the nation.