Global health threats, disease detection, and childhood development in Healthy People 2020

Healthy People 2020

Review of Three Articles from Healthy People 2020

Global Health

The goal of improved global health is to strengthen U.S. national security through global disease detection, response, prevention, and control strategies. Threats to health in one part of the world may have far reaching consequences that impact public health across the globe. The 2003 SARS epidemic and the 2009 H1N1 influenza outbreak are recent examples. Furthermore, improving the health of the global population promotes political stability, diplomacy, and economic growth worldwide.

The world and its economies are increasingly interdependent and international travel and commerce is becoming more prevalent. Expanding international trade introduces new health risks. A complex international distribution chain has resulted in potential international outbreaks due to food borne infections, poor quality pharmaceuticals, and contaminated consumer goods. Since the 1970s one or more new diseases have been identified annually. Rapid identification and control of emerging infectious diseases as well as other threats to public health, promotes health abroad, prevents the international spread of disease, and protects the health of the U.S. population.

Global Health concerns encompass more than infectious diseases. Non-communicable diseases are among the leading causes of disability worldwide. These conditions include diabetes and obesity, mental illness, substance abuse disorders, and injuries. As social and economic conditions in developing countries change and their health systems and surveillance improve, more focus will be needed to address non-communicable diseases, mental health, substance abuse disorders, and, especially, injuries.

National objectives in global health include reducing the number of cases of malaria reported in the United States, decreasing the tuberculosis (TB) case rate for immigrants living in the United States, increasing the number of Global Disease Detection Regional Centers worldwide to detect and contain emerging health threats, increasing the number of public health professionals trained by Global Disease Detection programs worldwide, and increasing diagnostic testing capacity in host countries and regionally through the Global Disease Detection program over the remainder of the decade ("Global Health, 2012).

Immunization and Infectious Diseases

The increase in life expectancy over the last century can be largely attributed to improvements in childhood survival rates related to reductions in infectious disease mortality due largely to immunizations. Currently immunization recommendations in the United States target seventeen vaccine-preventable diseases across the lifespan. Unfortunately, infectious diseases remain a major cause of illness, disability, and death. This is due in part to a more mobile society and the fact that diseases do not stop at geopolitical borders. Awareness of disease and completing prevention and treatment courses remain essential components for reducing infectious disease transmission.

Viral hepatitis, influenza, and tuberculosis (TB) remain among the leading causes of illness and death in the United States and annually place a heavy economic burden on individuals and society. Vaccines are among the most cost-effective clinical preventive services and are a core component of any preventive services package. Childhood immunization programs provide a very high return on investment. For each birth cohort vaccinated with the routine immunization schedule society saves 33,000 lives, prevents 14 million cases of disease, and reduces direct health care costs by $9.9 billion while saving $33.4 billion in indirect costs.

Currently about 42,000 adults and 300 children in the United States annually perish from vaccine-preventable diseases. Furthermore, communities with pockets of unvaccinated and under-vaccinated populations are at an increased risk. In 2008 there were 140 cases of imported measles reported, nearly a 300% increase over the previous year. New or replacement strains of vaccine-preventable disease seriously increase the threat of illnesses and death.

As the demographics of the population continue to shift, public health and health care systems will need to expand their capacity to protect the growing needs of a diverse and aging population. Providing culturally appropriate preventive health care is an immediate responsibility that will grow over the coming decade. Infectious diseases must be looked at in a global context due to increasing, international travel and trade, migration, importation of foods and agricultural practices, threats of bioterrorism, and the inappropriate use of antibiotics. National objectives center on these issues as well as increasing the number of persons given inoculations for all seventeen vaccine-preventable diseases ("Immunization and Infectious Diseases, 2012").