journal of public health

journal of public health

The Impact of Public Health Policies on Society

1. Introduction

The present world economic depression has led by reaction to a great increase in public health activity without sound method. Measures for improvement in health are considered to be good per se, irrespective of the cost. But no nation has unlimited resources for health projects and the time and efforts of physicians and statesmen could be put to better advantage for attainable aims in public health. It is here that we must distinguish between the art of the possible and the ideal. These criteria of practicability derive added importance from existing international political and social situations. A project in one nation may endanger the stability of regions or aid the encroachment of a foreign power with the consequent suffering of many who otherwise might remain in good health. Public health is no longer a local family affair. The advance of preventive medicine necessitates constant new appraisals of community health with general administrative policies and their political and social implications. All administrative measures may be rated in terms of war preventive public health measures are in the realm of economy and the international good. The recent abandonment of many silver standard countries has provided the opportunity for controlled inflation and exchange depreciation as a means of economic betterment of health at a lower cost in labor and materials than was heretofore possible. It is to such measures, however repugnant to certain powerful economic groups, that we can in future look for the solution of many acute problems in public health.

The several centuries’ struggle against infectious diseases has provided an economical justification – at least for the Western world – for public health measures. Before the 20th century, the control of plagues and wars did not give much opportunity for the extension of the average length of life of human beings. But the prevention of illness and the relief of suffering have always been part of the moral obligation of the physician. As we are able to accomplish this in an ever-widening sphere for all social classes, it is clear that we in public health need a principle by which we may decide what measures are worth while for improving the public health at great cost in effort, money, and personnel.

2. Current Challenges in Public Health

Due to the increasing concern and wide-reaching implications of obesity, and the fact that it is preventable, it is becoming a public health and government priority across many different countries at this present time. There has been a call for action by the WHO, which has recognized the issue of obesity as one of the most important public health challenges of the 21st century. The vastness and implications of obesity can be likened to that of alcohol and drug prevention, with the weight of future public health resting on policy and preventive measures being greater than that of treatment at a clinical level. Measures are being taken to try and understand the complex nature of the determinants of obesity in order to halt and reverse the current trend. This has led to an increase in research on obesity and epidemiology, and it is a long-term goal to reduce obesity and obesity-related diseases.

An example of a new public health challenge is obesity. Globally, it has been recognized as a serious public health issue. In particular, obesity has become a major problem in the West, with over 550 million people considered obese. The UK and USA are prime examples, with over 20% of the population being obese, and figures are steadily increasing. The UK, using the USA as an example, has predicted that similar numbers in obesity would eventually occur, thus starting the program for tackling obesity as a future problem to public health in these nations. The rise in obesity has many implications for public health, with future generations facing lower life expectancy rates than their parents, decreased quality of life, and increased risk of premature death compared to those with a healthy weight. This is a major issue, as obesity is associated with a myriad of health problems, meaning that an increasing amount of resources would be in demand to combat these diseases in obese patients. The increased risk of heart disease and diabetes is of particular concern, especially with increasing numbers of younger sufferers. With the loss of functional ability and vitality in the elderly, it is predicted that there would be an increased burden of care for those obese or suffering from obesity-related diseases. This can have further implications.

There are many challenges currently facing public health. Some of these challenges are rooted in the past, covered in the previous chapter. Others are new and have arisen as society has changed and the environment careened out of control. An example of a past challenge is the continued efforts to eradicate malaria. In the past, this has proved a very difficult task primarily due to the fact that the malaria parasite comes in four different forms and can easily adapt. This evolution has made malaria easy to become resistant to anti-malarial drugs. This has huge implications for public health. For example, in Cambodia, where the first-line drugs are no longer effective, around half the nation is infected with the malaria parasite. Due to the past and the belief that malaria was irrelevant to the current situation, less developed countries are having a harder time defeating the disease, as there are increased numbers of carriers and the environment allows for easy transmission. This disease was once present in countries such as England; therefore, there is a continued risk of the disease re-emerging in these areas. This is obviously an issue in Japan with the current concern over malaria being brought in by carriers from other countries’ armed forces. Sustained and increased funding is being put into malaria research and combating the disease, and it may be that future public health may be affected in a positive light, with an example being the recent discovery of a malaria vaccine.

3. The Role of Public Health Policies

Public health policies can potentially promote health and reduce health risk behaviors at an individual level. This could be aimed at a particular demographic or the population as a whole. For example, the National Child Measurement Programme aims to reduce the prevalence of obesity in children in England by providing accurate and consistent data on the weight of primary school children. This information can be used by parents to make more informed choices about their children’s lifestyle and by the government to better understand the health needs of children and plan services.

Public health tends to focus on prevention as opposed to treatment. This is one of the reasons why it is often undervalued by the public and the medical community. An example of this is smoking cessation. The health benefits and money saved from preventing someone smoking are far greater than the treatment for a smoking-related disease.

Public health policies require a means of evaluation to assess whether they have been successful in achieving their aims. As well as recommending areas for improvement, an evaluation can help build a case for future policies and provide accountability for politicians and funding bodies.

Public health policies play a vital role in improving the state of health in a society. This may be influenced by public health needs, changing practice of health care, and new emerging diseases. It is important that these policies change the health of the population, and most importantly, improve the health inequalities found in societies. As daunting a task as this may seem, it is important to assess these policies in an accurate and effective manner.

4. Successful Implementation of Public Health Policies

Another example of health policy implementation timing and its associated effects stem from the recent healthcare reform legislation. Passage of the bill was heralded as a historical event that brought the United States closer to a state of near-universal healthcare access. Unfortunately, the downstream effects of the bill have left it unclear whether or not current and future implementation of the bill will result in beneficial effects on preventing disease, improving access to care for vulnerable populations, or reducing healthcare disparities. During economic crises, like the one occurring now, public health initiatives tend to lose funding and no longer become a priority for the government. This ultimately leads to an effect on health equality in society and has happened in Ontario in the past as well as on a global scale.

The successful implementation of public health policies largely depends on the timing, effectiveness, and fairness of the policy and the downstream effects it has on society. In terms of timing, policies are often reactionary to current events. An example of this is post September 11th, 2001, when the United States public health policy shifted focus primarily to emergency preparedness issues. Due to the increased threat of bioterrorism, these policies have had significant downstream effects on government funding priorities even after the event no longer remained a threat. The goal of the policy was to protect society, but the long-term effects have yet to be fully understood.

5. Conclusion and Future Directions

Historical analyses of public health policy have much to offer in our efforts to improve the health of the public. First of all, the rich data contained in these studies serve as a wealth of experience. Case studies inform us of the complex and dynamic nature of health and of the multifarious influences on health policy. These insights can help policymakers today to better understand the factors that determine the health of a population and the complex interplay that occurs between health policy and improvements in health. More specifically, policymakers can learn from past successes, failures, and unintended consequences of various policies. Histories of health policy also bring to the forefront the importance of social values and political ideology in framing health policy – issues that are often overlooked by scientists conducting clinical research. A clear understanding of the political determinants of health can inform strategies employed by health advocates seeking to improve the public’s health. In light of the current interest in diplomacy’s role in health, in global health initiatives, and in the narrowing health gap between different countries, there is much that could be learned from the successes and failures of different nations’ health policies. Finally, historical analyses can inform and frame current debates on health policy. An understanding of the historical context behind specific health issues allows us to better comprehend the arguments made by different sides and can reveal alternate solutions that were perhaps overlooked or never implemented.