One of the few benefits of the COVID-19 pandemic has been renewed attention on public health.
Health care is a frequent subject of policy debates, but Americans typically view it from the perspective of the individual or nuclear families. That narrow approach has resulted in Americans spending far more on health care than any other country while achieving mediocre results. A more comprehensive view will include public health, which can have as much impact on quality of life as our individual insurance or our personal doctor.
As the American Public Health Association explains: “Public health promotes and protects the health of people and the communities where they live, learn, work and play. While a doctor treats people who are sick, those of us working in public health try to prevent people from getting sick or injured in the first place. We also promote wellness by encouraging healthy behaviors.”
As the pandemic has demonstrated, public health is essential when a community response to a crisis is necessary. Tracking infections during the early days of COVID and coordinating vaccine distribution when those vaccines became available helped keep a bad situation from being even worse.
So it is interesting to hear the priorities spelled out recently by Dr. Alan Melnick, Clark County’s director of Public Health. During a meeting of the county Board of Health, Melnick focused on environmental health and the monitoring of air, soil, water and food.
“What we do in our environmental health programs is focus on the interrelationships between people and their environment to promote health and to protect us,” he said.
It also is interesting to see U.S. Surgeon General Vivek Murthy focus attention on the impact of pandemic-related isolation.
“Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health,” Murthy wrote in an advisory issued in May. “Given the significant health consequences of loneliness and isolation, we must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders.”
Whether at the county level or the national level, public health should be viewed as an investment. Tackling issues from a broad, communal perspective is less expensive than treating the resultant health problems at the individual level. According to the surgeon general’s advisory, the consequences of isolation and loneliness include a 29 percent increase in the risk of heart disease and a 50 percent increase in the risk of dementia for older adults. Additional impacts also add to the cost of American health care.
But despite the benefits from an ounce of prevention, policymakers are reluctant to adequately fund public health initiatives. According to the National Health Expenditure Accounts, Americans spent $4.3 trillion on health care in 2021 — more than one-sixth of the gross domestic product. Only 3 percent of that spending was on public health initiatives — the kind that can reduce costs elsewhere.
As the Centers for Disease Control and Prevention explains: “Public health is the science of protecting and improving the health of people and their communities. This work is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases.”
Investing in that science should be a priority for Congress and state legislatures.
