Public Health Contemporary Issues

PUBLIC HEALTH

Contemporary Issues in Public Health

Part 1: Introduction to Public Health

From the onset, it would be prudent to note that there is no assigned definition to public health. In essence, this means that in the past, a wide range of definitions have been assigned to public health by various authors. Public health, according to the Centers for Disease Control and Prevention CDC (2018), could be perceived as “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.” This is the definition to public health that will be embraced in this text. In basic terms, this means that public health largely concerns itself with not only the protection, but also the promotion of the health as well as wellbeing of individuals and communities. To a large extent, this is an undertaking that can only be accomplished via the implementation of the most viable strategies towards the prevention of disease and injury – which could be inclusive of research efforts and advancement of healthy lifestyles. The CDC Foundation (2020) is categorical that from the larger perspective, public health is inherently focused on securing the health and wellbeing of entire populations. In this case, it would be prudent to note that the said populations could “be as small as a local neighborhood, or as big as an entire country or region of the world” (CDC Foundation, 2020).

The relevance of public health cannot be overstated. This is more so the case given that it seeks to promote and advance the welfare of entire populations. As a matter of fact, societies can achieve little in other realms (i.e. on the economic front) without having in place measures and strategies to secure the health and wellbeing of populations. For instance, without clear strategies to contain the spread of infectious illnesses, jurisdictions cannot be able to pursue their developmental agenda. This we have all witnessed in the recent past – whereby the COVID-19 pandemic has hit nations and communities hard. As a consequence of the said pandemic, some nations, especially those that were unable to reign in the spread of the disease from early on, are staring at economic decline. Thus, in the final analysis, investment in public health ought to be a number one priority. The role of the government (at the federal, state, as well as local levels) remains instrumental on this front. This is more so the case given that “governmental responsibilities for public health extend beyond voluntary activities and services to include additional authorities such as quarantine, mandatory immunization laws, and regulatory authorities” (Riegelman and Kirkwood, 2018). The government, however, has to partner with other stakeholders so as to truly advance the public health agenda.

Part 2: Public Health Events/Issues

In recent times, we have had a number of public health concerns affecting communities at the global, national, state, as well as local levels. It would be prudent to highlight some of these concerns. The concerns that will be identified in this section are inclusive of: the COVID-19 pandemic; nutrition, physical activity and obesity; and prescription drug overdoses.

a) COVID-19 Pandemic

COVID-19, according to the World Health Organization – WHO (2020), could simply be described as an infectious disease that was only recently discovered (approximately 1 year ago) and continues to wreak havoc across the globe. It is caused by the novel coronavirus. It is important to note that as WHO further points out, this particular disease has been associated with symptoms that vary from one person to another. However, some of the more common symptoms of the said disease are inclusive of, but they are not limited to; tiredness, dry cough, and fever. Other serious symptoms of the disease include pressure or pain in the chest cavity and shortness of breath/difficulty breathing. As WHO observes, those likely to experience the more serious set of symptoms are inclusive of individuals who have compromised immunity or have other underlying medical issues. Others in the category of people likely to develop serious symptoms are older persons.

There is no doubt at all that COVID-19 is a critical public health issue – not only in the U.S. but across the world as well. As a matter of fact, the pandemic’s effect on mortality has been immense. The media has been at the forefront in tracking the progress of the virus both in the country and across the world. Further, the media has generally performed well in efforts to ensure that people are aware of the most effective approaches to contain the disease. At the time of writing this text (29th Nov 2020), the novel coronavirus had, as Mzezewa and Cahalan (2020) point out, claimed the lives of more than 250,000 people in the country. The number of those infected with the virus had surpassed 4 million cases (Mzezewa and Cahalan, 2020). Infection rates and the death toll continue to raise on a daily basis. The authors are of the opinion that the infection rates are likely to continue increasing going forward. Indeed, according to Tom Inglesby – John Hopkins University Center for Health Security director – the said increase in infections will be as a consequence of people’s movement across the country during the holiday seasons (Mzezewa and Cahalan, 2020). It should be noted that according to Mzezewa and Cahalan (2020), the 4 million milestone was reached as persons “traveled by the millions for the long Thanksgiving weekend and amid a Black Friday that saw some store crowding, even as merchants guided customers to online sales and limit in-person shopping.” Crowding in public places has been an outright contravention of the guidelines set by various agencies to limit the spread of the virus. Some of the strategies to limit the spread of the virus that have been proposed by various health agencies include adherence to social distance protocols, utilization of alcohol-based hand sanitizers, and wearing of face masks when in public. This is more so the case given that as WHO (2020) points out, “the COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes.”

There have been concerted efforts to develop a vaccine so as to prevent more infections and deaths. Trials are at advanced stages and there are indications that within the next few months (or even weeks), an effective vaccine will be rolled out to the general population to help stem the crisis. According to Mckeever (2020), global efforts to develop and avail vaccines are being coordinated by the World Health Organization. It should, however, be noted that as the author further points out, there are still numerous potential challenges ahead especially with regard to the production and distribution of the said vaccine.

b) Nutrition, Physical Activity and Obesity

Obesity has variously been referred to as a silent epidemic. According to the national Institute of Diabetes and Digestive and Kidney Diseases – NIDDK (2017), an individual could be deemed obese if his or her weight happens to be higher than the weight that is regarded normal following the relevant adjustments for height. As per this definition, one in every three adults in the U.S. is considered obese (NIDDK, 2017). Children and adolescents have not been spared either. Indeed, as NIDDK further observes, “about 1 in 6 children and adolescents ages 2 to 19 are considered to have obesity.” Obesity is not a concern only in the U.S. As a feature on Deutsche Welle (DW) points out, obesity has been on an upward trend in many developing countries – with the culprit in this case being increased consumption of processed foods (DW, 2020). On the basis of these figures, it is clear why obesity has been branded a silent epidemic – it is ‘silent’ because while the prevalence of the same is shocking, nothing much has been done to bring this issue to the attention of the public. As a matter of fact, the issue appears to have been given a partial blackout by the media. The harms of the same have not been given the deserved attention.

Obesity is a serious public health concern because it has been associated with a wide range of adverse health outcomes. According to the Centers for Disease Control and Prevention – CDC (2020), in comparison to people of normal weight, obese people happen to be at an increased risk of a wide range of health complications. Some of the said complications, as CDC further points out, are inclusive of, but they are not limited to hypertension (high blood pressure), diabetes type II, coronary heart disease, osteoarthritis, gallbladder disease, and stroke. Further, according to the CDC, such persons are also likely to experience decreased quality of life. This is more so the case given that obesity causes impairment in the performance of various activities in life, i.e. with regard to physical functioning. On the basis of these findings, there is a clear need for proper strategies to be implemented in an attempt to reign in the same.

Some of the key factors that drive obesity are little physical activity and poor nutrition. Indeed, according to an article appearing on the Harvard Medical School website, “sedentary work and inert recreation account for a large portion of the obesity epidemic — but modern eating also deserves a share of the blame” (Harvard Medical School, 2012). It therefore follows that this is exactly where efforts to reign in this particular silent epidemic ought to commence. This effectively means that in addition to encouraging people to consume foods that do not pack a lot of calories, stakeholders in public health should also stress the relevance of engaging in constant physical activity and avoiding a sedentary lifestyle.

c) Prescription Drug Overdoses

Yet another issue that is of specific public health concern is prescription drug overdose. Prescription drug abuse could be defined as the utilization of a prescription drug for any other purpose apart from that for which it was intended (Mayo Clinic, 2018). The prescription drugs that are most abused by people in the U.S. are inclusive of: stimulants, sedatives and anti-anxiety medications, and opioids (Mayo Clinic, 2018). The Centers for Disease Control and Prevention – CDC (2020) refers to prescription drug abuse and overdose as America’s drug overdose epidemic.

It is important to note that according to CDC, U.S. communities continue to be severely impacted by deaths related to drug overdose. As a matter of fact, as CDC further observes, within the last two decades, drug overdose has claimed the lives of more than 750,000 people. In essence, “two out of three overdose deaths involved an opioid like prescription opioids, heroin, or synthetic opioids (like fentanyl)” (CDC, 2020). On this basis, this is an issue that calls for the intervention of the relevant stakeholders in public health.

It should also be noted that this is yet another issue that has not attracted its fair share of publicity. In essence, there has been little media coverage on the same. However, a few article have been penned linking the recent spike in abuse of prescription drugs to the COVID-19 pandemic. For instance, writing for Washington Post, Stobbe and Sainz (2020) observe that this year, deaths linked to drug overdose are likely to reach a new high. In the words of the authors, his trend has been attributed to “the pandemic, which has left people stressed and isolated, disrupted treatment and recovery programs, and contributed to an increasingly dangerous illicit drug supply” (Stobbe and Sainz, 2020). As the authors further point out, the latest data indicates that the biggest drug killer in recent times has been fentanyl - which happens to be one of the most potent synthetic opioids formally used (and approved) for the treatment of severe pain.