Public health in the U.S. is facing a lot of challenges. It has, however, withstood and adapted to some of these challenges. The challenges have been handled by proper legal frameworks, and the creation of functional institutions to carry out public health policies. The institutions that implement these policies formulate and carry out important public health and safety programs. They also add to the knowledge base in health by conducting research in various public health domains. The research carried out by these institutions has influenced practice and production in major sectors of world economies (Fuchs, 2009). The creation of functional administrative units, through the formulation of a supportive legal framework for their functioning, is the biggest strength of public health.
The Department of Health and Human Services is one of these institutions. It can invoke the Public Health Service Act, and declare public health emergencies. It can do this for any assessed situation that is found to threaten public health. The act, when invoked, compels federal authorities to put measures in place to counter these threats. The Federal Food Drug and Cosmetic Act (FFDCA) and the Public Health Service Act are the key legislations that support public health. The National Environmental Policy Act gives the Environmental Protection Agency (EPA) authority to make sure that fundamentals such as water and air are safe.
The U.S. Department of Agriculture, through the FFDCA, ensures that animal and plant food products are safe for human consumption. Public health emergency services are provided by the Department of Health and Human Services (HHS), through the Office of Public Health Emergency Preparedness. Several other public health agencies also fall under the HHS. They include the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the Health Resources and Services Administration.
A Near-Future Challenge for Public Health
Public health is charged with the function of policy development. This is a complex task requiring inputs from science as well as from the sociopolitical domain. The policies developed need to safeguard the health of the public at all costs. Optimizing healthcare provision in the prevailing socio-economic and political environment has proved to be a great challenge. The challenge calls for an increase in advocacy for supportive legislation and engagement with stakeholders from all sectors.
They are important in achieving consensus on public health issues (California Health Policy Forum, 2007). The diversity and resultant contention that exist in the principle of healthcare coverage in the U.S., pose a challenge to public health. The main principle of coverage has been diluted by the conflict of interest of the various stakeholders including Medicaid, types of private insurance, Medicare, and veteran services offered to the uninsured.
Restructuring health care to meet the level of universal coverage remains a big challenge in healthcare. It includes the challenge of budgeting healthcare resources. There is a growing contention about the prioritization of some public healthcare problems over others. Funding of prioritized problems is also likely to pose a challenge. The problem of defining and eliminating wastage in healthcare budgeting is also hard to resolve.
Funding decisions are complicated by conflicting ideas among healthcare policymakers as well as by the state of the economy, and the existing sociopolitical environment. Future changes in the economy and politics of the day will affect public healthcare provision. It is almost unachievable to cushion healthcare from the adversities that may come with these changes.
Climate Change
Climate change is an issue that public health is obliged to respond to because it affects the health of the public directly. There is a growing need for increased advocacy against environmentally hazardous substances.
Most public health problems stem directly from substances that affect the quality of air, water, and food (Scutchfield et al, 2009). The biggest upcoming problem for public health is to challenge the antagonism posed by stakeholders in production against public health and safety policies. Public health advocacy groups, organizations, and institutions are faced with the task of popularizing science-based evidence, which may convince lawmakers to cushion the public from hazardous products and by-products from some manufacturers. Such advocacy relies directly on the political environment as well as on the economic interests of the beneficiaries.
To ease the formulation of appropriate laws for public health and safety, the concept of public health has been refined to encompass preventive care (California Health Policy Forum, 2007). Preventive measures included in it, safeguard the public against health hazards. There is a need to formulate appropriate laws to support the implementation of public health programs that are grounded on preventive public healthcare. The manipulative effect that investors in the production sector have on the economic policies as well as on the political environment poses a great challenge to public health policies.
There also is a growing need for an increase in the understanding of the impact that climate change has on fueling health inequities (Frumkin et al, 2008). Populations that live in low-income residences, where the waste management is an issue, will be hit hardest by an increase in vectors of food and water-borne diseases. An increase in temperatures also affects the overall composition of air and will increase cases of respiratory diseases through the vaporization of dangerous gases from unmanaged waste. The rising temperature will also cause shortages in the global food supply and resultant malnutrition, mental health problems, an increase in cases of cataracts and cancers as a result of ozone depletion, and many more health issues.
References
California Health Policy Forum. (2007). Solutions-oriented conversations improving health policy. Understanding the United States public healthcare system, 2.
Frumkin, H., Hess, J., Luber, G., Malilay, J., and McGeehin, M. (2008). Climate Change: The Public Health Response. American Journal of Public Health 98(3): 435–445.
Fuchs, R.V. (2009) A collection of articles on healthcare reform. Healthcare Reform, 1-2.
Scutchfield F. D., Keck C. W (2009). Principles of Public Health Practice, (3), Delmar.