This paper provides a broad introduction to public health and examines three pressing contemporary issues affecting communities at local, national, and global levels. Beginning with a working definition of public health drawn from the CDC, the paper explores the importance of population-level health protection and government responsibility. It then analyzes the COVID-19 pandemic, the obesity epidemic linked to poor nutrition and physical inactivity, and the prescription drug overdose crisis — particularly involving opioids. The paper concludes by reflecting on societal gaps in public health awareness and recommending increased funding and media engagement to better educate the public on disease prevention.
From the outset, it is worth noting that there is no single universally assigned definition of public health. In the past, a wide range of definitions have been offered by various authors. Public health, according to the Centers for Disease Control and Prevention (CDC, 2018), can 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 that will be embraced throughout this paper. In basic terms, public health largely concerns itself with not only the protection but also the promotion of the health and wellbeing of individuals and communities. To a large extent, this can only be accomplished through the implementation of viable strategies for the prevention of disease and injury — which may include research efforts and the advancement of healthy lifestyles. The CDC Foundation (2020) is clear that, from a broader perspective, public health is fundamentally focused on securing the health and wellbeing of entire populations. These 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, particularly given that it seeks to promote and advance the welfare of entire populations. Societies can achieve little in other realms — such as on the economic front — without having in place measures and strategies to secure the health and wellbeing of their people. For instance, without clear strategies to contain the spread of infectious illnesses, jurisdictions cannot effectively pursue their developmental agendas. This has been demonstrated in recent times, as the COVID-19 pandemic has hit nations and communities hard. As a consequence, some nations — especially those that were unable to contain the spread of the disease early on — now face economic decline. Thus, investment in public health should be a top priority. The role of government at the federal, state, and local levels remains instrumental in this regard, 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 must, however, partner with other stakeholders to truly advance the public health agenda.
In recent times, a number of public health concerns have affected communities at the global, national, state, and local levels. Three of the most pressing are: the COVID-19 pandemic; nutrition, physical activity, and obesity; and prescription drug overdoses.
COVID-19, according to the World Health Organization (WHO, 2020), is an infectious disease that was recently discovered and continues to cause widespread harm across the globe. It is caused by the novel coronavirus. As WHO further notes, the disease has been associated with symptoms that vary from person to person. The more common symptoms include tiredness, dry cough, and fever. More serious symptoms include pressure or pain in the chest and shortness of breath or difficulty breathing. Those most likely to experience serious symptoms include individuals with compromised immunity or underlying medical conditions, as well as older persons.
There is no doubt that COVID-19 represents a critical public health issue — not only in the United States but worldwide. The pandemic's effect on mortality has been immense. The media has been at the forefront in tracking the progress of the virus both domestically and internationally, and has generally performed well in ensuring that people are aware of the most effective approaches to containing the disease. At the time of writing (November 29, 2020), the novel coronavirus had, as Mzezewa and Cahalan (2020) noted, claimed the lives of more than 250,000 people in the United States, and the number of confirmed infections had surpassed 4 million cases. Infection rates and the death toll continued to rise daily. According to Tom Inglesby, director of the Johns Hopkins University Center for Health Security, continued increases in infections were expected as a consequence of people's movement across the country during the holiday season (Mzezewa and Cahalan, 2020). The 4 million milestone was reached as people "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 limited in-person shopping" (Mzezewa and Cahalan, 2020). Crowding in public places represented a clear violation of the guidelines set by various health agencies to limit the spread of the virus. Recommended strategies to limit transmission include adherence to social distancing protocols, use of alcohol-based hand sanitizers, and wearing face masks in public — particularly because, as WHO (2020) notes, "the COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes."
Concerted efforts have been made to develop a vaccine to prevent further infections and deaths. Trials reached advanced stages, with indications that within the following months an effective vaccine would be rolled out to the general population. According to Mckeever (2020), global efforts to develop and distribute vaccines were being coordinated by the World Health Organization. However, as the author also noted, numerous challenges remained ahead, particularly regarding the production and distribution of the vaccine.
Obesity has frequently been described as a silent epidemic. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, 2017), an individual may be considered obese if his or her weight is higher than what is regarded as normal following the relevant adjustments for height. By this definition, one in every three adults in the United States is considered obese (NIDDK, 2017). Children and adolescents have not been spared: 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 limited to the United States. As Deutsche Welle (DW, 2020) reports, obesity has been on an upward trend in many developing countries, with increased consumption of processed foods serving as a key driver. These figures help explain why obesity has been labeled a silent epidemic — it is "silent" because, despite the shocking prevalence, relatively little has been done to raise public awareness of the issue. The media has given it insufficient coverage, and the harms of obesity have not received the attention they deserve.
Obesity is a serious public health concern because it has been linked to a wide range of adverse health outcomes. According to the CDC (2020), obese individuals face a higher risk of numerous health complications compared to people of normal weight. These complications include, but are not limited to, hypertension (high blood pressure), type II diabetes, coronary heart disease, osteoarthritis, gallbladder disease, and stroke. Obese individuals are also likely to experience a decreased quality of life, particularly due to impairments in physical functioning. These findings underscore the need for effective strategies to address the epidemic.
Among the key factors driving obesity are low levels of physical activity and poor nutrition. According to an article 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 follows, then, that this is precisely where efforts to address the silent epidemic must begin. In addition to encouraging people to consume foods that are lower in calories, public health stakeholders should also emphasize the importance of regular physical activity and avoiding a sedentary lifestyle.
Another issue of significant public health concern is prescription drug overdose. Prescription drug abuse can be defined as the use of a prescription drug for any purpose other than that for which it was intended (Mayo Clinic, 2018). The prescription drugs most commonly abused in the United States include stimulants, sedatives and anti-anxiety medications, and opioids (Mayo Clinic, 2018). The CDC (2020) refers to prescription drug abuse and overdose as America's drug overdose epidemic.
According to the CDC, U.S. communities continue to be severely impacted by drug overdose deaths. Over the past two decades, drug overdose has claimed the lives of more than 750,000 people. Furthermore, "two out of three overdose deaths involved an opioid like prescription opioids, heroin, or synthetic opioids (like fentanyl)" (CDC, 2020). This reality demands intervention from relevant public health stakeholders.
This issue has also not attracted the media attention it deserves, with relatively limited coverage in mainstream outlets. However, a number of articles have linked the recent spike in prescription drug abuse to the COVID-19 pandemic. Writing for The Washington Post, Stobbe and Sainz (2020) observe that drug overdose deaths in 2020 were on track to reach a new high — a trend 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 note, the latest data indicates that the biggest drug killer in recent times has been fentanyl, one of the most potent synthetic opioids formally used and approved for the treatment of severe pain.
While public health is widely acknowledged as important, efforts to embrace and implement its core principles often appear halfhearted. People continue to ignore policies and guidelines that advance the public health agenda — as demonstrated by widespread disregard for COVID-19 prevention measures such as social distancing. Similarly, the media has been slow to report on and sensitize the public to serious but less visible epidemics such as obesity and opioid abuse. The consequences are significant: most people today continue to be affected by diseases and conditions that are largely preventable. Common health conditions linked to obesity and overweight — including coronary heart disease, type II diabetes, and high blood pressure — remain widespread precisely because prevention efforts have not reached a sufficient proportion of the population.
There is much that could be done to improve society's understanding and perception of public health. Increased funding to organizations actively involved in public health — such as the World Health Organization — would be a meaningful step forward. It would also be beneficial for the media to play a more proactive role in educating the public on key aspects of public health, with specific emphasis on disease prevention through lifestyle changes and other practical measures. Ultimately, a more engaged and informed public is essential to improving population health outcomes.
Centers for Disease Control and Prevention CDC (2018). Introduction to Public Health. https://www.cdc.gov/publichealth101/public-health.html
Centers for Disease Control and Prevention – CDC (2020). The Health Effects of Overweight and Obesity.
Centers for Disease Control and Prevention – CDC (2020). America's Drug Overdose Epidemic: Putting Data to Action.
CDC Foundation (2020). What is Public Health? https://www.cdcfoundation.org/what-public-health
Deutsche Welle – DW (2020). Obesity – a global problem.
"Opioid crisis, overdose deaths, and pandemic link"
"Gaps in public awareness and policy recommendations"
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