Although the United States offers some of the highest quality health care in the world, there are still many difficult challenges left to solve. From heart disease and chronic illness to alcoholism and prescription drug abuse, there’s no shortage of public health problems that need to be addressed. And while public health professionals are constantly engaged at the local and national levels, making a positive impact isn’t easy.
Tackling key health issues in America requires input from a diverse range of stakeholders, including government agencies, nonprofit organizations, and private medical facilities. The ability to collaborate across industry lines is essential, as breakthrough medical treatments and public health initiatives depend on experts with different specializations. For example, educating citizens about the risks of excessive alcohol consumption relies on the knowledge of medical practitioners, the communication skills of health educators and the policy experience of lawmakers. But what exactly is a public health problem and how do experts keep track of them over time?
What makes something a public health problem?
Public health is the science of improving the well-being of communities through research, health programs, policies, and education. Unlike the health care field, public health is more about protecting entire populations (CDC Foundation, 2018). This could be something as small as a rural neighborhood, or as large as an entire country. Rather than treating existing medical issues, public health professionals try to prevent problems by promoting healthy lifestyles, designing outreach campaigns, and advising policymakers. They also work to eliminate health disparities by advocating for health care equity and accessibility.
A public health problem, therefore, is a medical issue that affects a significant portion of a specific population. Some examples include chronic illnesses like Type 2 diabetes, infectious diseases such as HIV and tuberculosis, mental health challenges, and even motor vehicle accidents. The Centers for Disease Control and Prevention (CDC), along with other government agencies, collect detailed information on the leading causes of death, injuries, illnesses, and risk factors for medical conditions to help keep track of these and other public health issues. Using this information, data analysts and statisticians can create raw statistics about diseases and mortality. Once a public health problem has been identified, medical experts and public health professionals band together to develop prevention techniques and educational materials that can be disseminated to the target population.
While every public health initiative is different in terms of funding and institutional support, most depend on the government in some way. For example, the mandatory immunization laws enacted in the U.S. during the late 1980s helped reduce the number of polio cases by 99.9% (Kaiser Family Foundation, 2019). Of course, these vaccines were developed by medical experts over years of research and development, which would not have been possible without the direct involvement of the World Health Organization, the CDC, the United Nations Children’s Fund, and other health organizations.
Top public health problems for the modern age
Despite the rapid advancement of medical treatments and technologies, there are still many public health problems plaguing industrialized nations around the world. According to a 2018 report from the CDC, the life expectancy for the U.S. population declined to 78.6 years in 2017 (Centers for Disease Control and Prevention, 2018). The leading causes of death, which accounted for 74% of all mortalities, included:
- Heart disease
- Unintentional injuries
- Chronic lower respiratory diseases
- Alzheimer’s disease
- Influenza and pneumonia
- Kidney disease
While these specific causes represent key public health concerns, there are a variety of medical issues and behaviors that contribute to their growing mortality rates. For example, individuals who are not physically active are often at higher risk of heart disease, stroke, and diabetes (American Heart Association, 2016). As such, raw statistics rarely paint a complete picture of health issues in America, which is why the CDC focuses on prevention-based initiatives and education programs. With that in mind, here are 5 of the top public health problems the CDC is currently tracking, both at home and abroad.
Heart disease and stroke
Heart disease is currently the leading cause of death both in the U.S. and worldwide. On average, someone dies from cardiovascular disease every 38 seconds, which is around 2,303 deaths per day (Centers for Disease Control and Prevention, 2019). The term “heart disease” is actually used to describe several different conditions, many of which relate to the buildup of plaque in a person’s arteries or irregular heart rhythms. Unlike infectious diseases, this public health problem is highly preventable and the risk factors are well understood by medical professionals. Some of the health behaviors that contribute to heart disease include:
- Tobacco use
- Physical inactivity
- Poor nutrition
Stroke is another possible outcome of poor heart health, leading to an average of 389.4 deaths each day (American Heart Association, 2019). Of course, congenital conditions can increase a person’s chances of experiencing a heart attack or stroke, but staying active and eating healthy are essential for managing most cardiovascular diseases.
Health organizations have been working to reduce the rate of heart disease for decades, mostly through public awareness initiatives and improved screening programs. Despite their efforts, the health care costs associated with cardiovascular disease are projected to exceed $1 trillion by 2035 (RTI International, 2017). To help control these expenses, the CDC has recommended promoting team-based care and clinical decision-support systems focused on prevention and healthy living.
Excessive alcohol use continues to be a serious public health issue in developed countries around the world. An estimated 88,000 people in the U.S. die from alcohol-related causes annually, such as alcoholic liver disease, hypertension and heart attacks, and strokes (National Institute on Alcohol Abuse and Alcoholism, 2019). While these conditions typically arise from prolonged periods of binge drinking and alcohol dependency, more moderate drinkers can still experience certain harmful long-term effects of alcohol consumption. These include high blood pressure, digestive problems, depression and anxiety, and even cancer. Driving under the influence is another key problem, as more than 10,000 people died in alcohol-impaired driving crashes during 2016, accounting for 28% of all traffic-related mortalities in the U.S. (National Institute on Alcohol Abuse and Alcoholism, 2019).
Alongside the agency’s outreach and public education efforts, the CDC and its partner organizations have proposed various evidence-based policies that are still under review. One recommendation is to increase state excise taxes on beer, distilled spirits and wine (Centers for Disease Control and Prevention, 2019). The hope is that the higher price tag will dissuade individuals from binge drinking, thus reducing alcohol-related harms. The CDC has also suggested regulating alcohol outlet density and providing adults with additional screening and intervention resources.
The human immunodeficiency virus (HIV) is widely considered the most dangerous sexually transmitted disease on the planet. Once contracted, HIV attacks a person’s white blood cells, making them more vulnerable to other types of infections. Also, HIV can lead to acquired immunodeficiency syndrome (AIDS), which is incurable and devastates a patient’s immune system. According to the Joint United Nations Programme on HIV and AIDS, the virus caused around 770,000 deaths worldwide in 2018 – which, though still high, is 55% lower than the peak rate of infection during 2004 (U.S. Department of Health & Human Services, 2019). Despite this decline, there were approximately 37.9 million people diagnosed with HIV/AIDS in 2018, many of whom live in resource-poor countries that do not have access to high-quality health care.
Since HIV was first discovered in 1983, health experts and government officials have been working to reduce the rate of infection through new treatments, screening programs, and other public health initiatives. One of the earliest campaigns involved advocating for safe-sex education and contraception devices, though many countries lacked key heath care resources and services to implement distribution of such tools and ensure sexually active individuals were instructed in their correct use. In fact, the CDC estimates that about 4 in 5 people who could benefit from medicine to prevent HIV aren’t receiving it (Centers for Disease Control and Prevention, 2019). More recently, health agencies and nonprofit organizations have focused on supporting scientific advances that have been shown to decrease new HIV infections. The CDC has also proposed facilitating state Medicaid reimbursement for HIV screening to alleviate the financial burden of preventive care.
Prescription drug overdose
Prescription drug abuse has skyrocketed over the past two decades, according to the CDC, leading to a fourfold increase in deadly overdoses between 1999 and 2018. It’s estimated that more than 70,000 people died from drug overdoses in 2017, with illicit and prescribed opiates accounting for 68% of all fatal cases (Centers for Disease Control and Prevention, 2019). One reason for the sharp rise in opiate abuse has to do with how certain pharmaceutical companies – like Purdue, manufacturer of OxyContin – marketed their drugs during the late 1990s (U.S. Department of Health & Human Services, 2019). Before it became clear that opioid pain relievers were highly addictive, doctors had already begun prescribing them to their patients at large doses. This led to widespread misuse of both prescription and non-prescription opioids – including heroin. The full consequences of this public health disaster have only recently been fully realized.
Once the U.S. government realized how serious the opioid epidemic had become, health organizations began comprehensively investigating the issue. In 2019, the CDC received $475 million for opioid overdose prevention and surveillance activities (Centers for Disease Control and Prevention, 2019). This funding allowed the agency to expand its state-based outreach efforts and develop new intervention programs. Currently, the CDC is focusing on 5 key strategies as part of its broader opioid abuse prevention framework, including:
- Conducting surveillance and research on drug abuse
- Improving data quality and tracking trends
- Supporting health care providers, health systems, and patients
- Empowering consumers to make healthy and safe choices
- Partnering with public safety officials and first responders
By creating a network of medical experts, public health professionals, and community organizers focused on drug abuse, the CDC is helping to bridge the gap between individual and community wellness. Moving forward, the agency will continue educating the public about opioids’ high rate of addiction and dependency, while also supporting local efforts to reduce mortality rates.
Antibiotics have been instrumental in managing a variety of infectious diseases, but certain viruses and bacteria have started developing resistances to modern medicines. This has made treating infections more difficult, from pneumonia and influenza to tuberculosis and other serious conditions. Antibiotic resistance can also compromise surgeries and procedures such as chemotherapy. According to the World Health Organization, around 600,000 cases of tuberculosis were resistant to rifampicin (the most effective first-line antibiotic) in 2017 (World Health Organization, 2019). These types of drug resistance are often driven by the overuse of antimicrobials in patients, but also in animals used for food production. Another issue is that resource-poor countries don’t have the laboratory systems, public health workforce, and emergency management programs needed to effectively respond to antibiotic-resistant viruses (Centers for Disease Control and Prevention, 2016).
Starting in 2015, the WHO endorsed a global action plan aimed at addressing antimicrobial resistance through public outreach, improved health care standards, and international collaboration (World Health Organization, 2017). The project seeks to strengthen existing medical knowledge by enhancing health agencies’ surveillance and research capabilities. This includes optimizing the use of antimicrobial agents and investing in new medicines, diagnostics tools and vaccines. The CDC is also helping to address drug resistance through the AMR Challenge, a global initiative designed to improve antibiotic use and infection prevention (Centers for Disease Control and Prevention, 2018).
Other key public health problems
Beyond addressing the most pressing public health issues, medical experts and health educators also work to inform the general population about leading more healthy lifestyles overall. Typical initiatives in this vein focus on how staying physically active, eating nutritious food, and avoiding tobacco use can greatly reduce the risk of heart disease. Of course, persuading the general public to make changes to their daily routines can be difficult, especially if they are not suffering from any chronic illnesses.
One of the many concerns of the AHA, WHO, and HHS is tackling the growing issue of obesity in developed countries. Obesity rates have risen significantly among U.S. adults over the past decade, from 33.7% between 2007 and 2008 to 39.6% in 2016 (American Cancer Society, 2018). Being severely overweight is more than a cosmetic concern, as it can increase a person’s risk of diabetes, cardiovascular disease, and certain cancers. While public health professionals are continuously developing new programs to help reduce obesity rates, the decision to consistently practice healthy behaviors ultimately rests with the individual.
Foodborne illness is another top concern for health organizations and government agencies, as 1 in 6 Americans suffer from food-related complications each year (Centers for Disease Control and Prevention, 2018). Although the mortality rates aren’t as high as those associated with infectious diseases or vehicle accidents, the cost of treating foodborne illnesses is immense – around $15.6 billion is spent annually. Luckily, these conditions are entirely preventable, which is why the CDC and USDA have taken a leading role in promoting food safety at the local, state and federal levels.
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No matter where your interests or professional goals may lie, an MPH from UNR can provide the broad, research-based knowledge you need to tackle the toughest public health issues. This 45-credit graduate program can be completed in as few as two years and is 100% online, allowing you to advance your education while maintaining your current professional and personal commitments. Students also gain access to UNR’s vast alumni network and world-class faculty, which may help you locate employment opportunities within government agencies, health organizations, nonprofit groups, and private health care companies.
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CDC Foundation, 2018. What is Public Health? Retrieved from: https://www.cdcfoundation.org/what-public-health
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