Public Health Needs to Take New Leadership Role.
The public health field is losing ground to an overemphasis on curative medicine, a situation that can only be remedied if public health practitioners re-focus on the core social, cultural, and economic drivers that shape population health, two leading experts in the School of Public Health argue in the latest issue of JAMA.
In a Viewpoint piece, Dean Sandro Galea and George Annas, director of the Center for Health Law, Ethics & Human Rights, say that, in high-income countries, the so-called “’easy work’ of public health is done—sanitation, vaccination, and response to epidemics that form the bedrock of a healthy society.”
But the health problems of the 21st century, including the increased prevalence of chronic illnesses, health disparities, and the challenge of healthy aging, are more complex and require “solutions at the interstices of social, political, cultural, and economic domains, where public health’s role shifts from acting alone to engaging as a coordinator and motivator of various, sometimes unusual, partners in sectors not directly responsible for health.”
Galea and Annas say that health inequities remain at the core of public health’s mission, and that the drivers of those inequities “are the same drivers that have animated some of the difficult national social-justice conversations that have resurfaced” in the past several years.
They offer four main strategies to re-shape the public health agenda, including a “relentless prioritization” that puts a focus on “what matters most” to the health of populations, and a shift away from seeing public health as solely a government-mandated and financed activity.
“The burgeoning precision medicine agenda and the continuing emphasis on the treatment for cancer have captured the imagination of funding agencies and politics at the highest level,” they write. “The result is diversion of resources in the direction of individualized efforts at disease prediction through genomic approaches, and away from the structural changes, with broader population-based effects, that have long characterized public health action.”