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Chapter 9

Chapter 9. Future Challenges for Public Health in America. Chapter Objectives. Describe lessons learned from the threats and challenges faced by public health in the 21 st century Characterize the limitations and challenges facing public health in the new century

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Chapter 9

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  1. Chapter 9 Future Challenges for Public Health in America

  2. Chapter Objectives • Describe lessons learned from the threats and challenges faced by public health in the 21st century • Characterize the limitations and challenges facing public health in the new century • Determine how these limitations and challenges can be overcome

  3. Chapter Overview • Lessons from a Century of Progress in Public Health • Limitations of 21st Century Public Health • The Future of Public Health in 1988 and Two Decades Later • The Need for a More Effective Public Health System

  4. Century of Progress Source: From U.S. Dept. of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2010: Understanding and Improving Health. Rockville, MD: ODPHP; 2000.

  5. Emerging Threats Source: From Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States, 1994, U.S. Centers for Disease Control and Prevention, Atlanta, GA.

  6. Emerging Threats: Monkeypox Source: From Centers for Disease Control and Prevention. Update: multistate outbreak of monkeypox—Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, 2003. MMWR. 2003:52(27):642–646.

  7. Re-Emerging Threats: Tuberculosis Source: Reprinted from Centers for Disease Control and Prevention. Trends in tuberculosis incidence, United States, 2006. MMWR. 2007;56(11):245–250.

  8. Lessons from a Century of Progress in Public Health • Remarkable Achievements • Unfinished Agenda • Science and Social Values • Public Health System: a Work in Progress

  9. Heart Disease Cancer Stroke Chronic lower respiratory disease Unintentional injuries Diabetes Pneumonia/influenza Alzheimer’s disease Kidney disease 0 5 10 15 20 25 30 35 Percentage (of all deaths) Health Problems: Two Different Views Leading Causes of Death* United States, 2000 Actual Causes of Death† United States, 2000 Tobacco Poor diet/physical inactivity Alcohol consumption Microbial agents (e.g., influenza, pneumonia) Toxic agents (e.g., pollutants, asbestos) Motor vehicles Firearms Sexual behavior Illicit drug use 0 5 10 15 20 Percentage (of all deaths) * Source: MininoAM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: final data for 2000. National Vital Statistics Reports 2002; 50(15):1-20. † Source: MokdadAH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291 (10): 1238-1246.

  10. Factors Contributing to Obesity Environmental Culture Socioeconomic Status Home Schools Work • Biological • Genetic • Metabolism • Medications • Behavioral • Diet • Physical Activity

  11. Factors Contributing to Obesity • Biological • Genetic • Metabolism • Medications • Behavioral • Diet • Physical Activity • Environmental • Culture • Socioeconomic status • Home • Schools • Work

  12. The Future of Public Health • 1988 IOM Report, The Future of Public Health • 2002 IOM Follow-Up Report

  13. Need for a More EffectivePublic Health System • Easy problems have already been solved • To a hammer, the entire world looks like a nail • A friend in need is a friend indeed • You get what you pay for • It’s not my job?

  14. Discussion • What was the most important achievement of public health in the twentieth century? Why? • What will be the most important achievement of public health in the twenty-first century? Why?

  15. Discussion • Using a scale from 1 to 10, how effective is the public health system in the United States? How did you arrive at this rating? • What do you think are the most important new or expanded roles for public health in the twenty-first century?

  16. Discussion • Your state receives $100 million annually from tobacco settlement funds. What strategies and programs should receive funding? Why? • How has your understanding of what public health is and how it works changed after examining the topics in this book?

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