The title of the CDC report, Ten Great Public Health Achievements --- United States, 2001—2010, explains its purpose quite clearly. It highlights the most noteworthy public health achievements that have occurred over the past decade. Reading the list, I see that many interventions I would have thought should be included were indeed incorporated. It is an accurate list, but it is interesting that many of these innovations are not exactly new ideas – for example, motor vehicle safety has been an advocated for and important problem for longer than just this decade. Rather, pressure on such issues had lead to vast further improvements. Therefore, these achievements are not completely accomplished – as long as there are still existing cases, further changes can be made to improve effectiveness and extend lives even more.
The first achievement that particularly resonated with me is the improvement in “public health preparedness and response.” Public Health entities have definitely improved their preparedness and responsiveness over the past decade given the terrorism threats, natural disasters, and epidemics our country has faced. For example, the 2001 anthrax attacks, Hurricane Katrina, E. Coli outbreaks, and the H1N1 virus of the past ten years had really struck a chord with the American public and its policy makers. I remember the fear surrounding all of these events, and am happy that improvements have been made in preparedness to lessen the effects of such situations on the health of populations.
Secondly, the “childhood lead poisoning prevention” achievement resonates with me because lead poisoning is something that has plagued the Baltimore for a very long time, and it particularly affects “black children and those living in poverty and in old, poorly maintained housing.” Last semester, I learned in a class entitled Baltimore & the Wire that there are many old row houses with lead paint and piping, and lead exposure causes possible brain damage in children. The city has been doing a good job of fixing up or knocking down old houses, as well as imposing building regulations to prevent such materials from being used in currently constructed houses. Nationwide, according the article, from 1976-1980 to 2003-2008 the percentage of children with blood lead levels greater than 10 µg/dL showed a declined from 88.2% to 0.9%. This is an amazing achievement that is especially relevant to the health of the city our University is located in, and affects the lives of many.
When the CDC publishes an article in 2020 highlighting the public health achievements of the past decade, I would like to see a significant decrease in the prevalence of antibiotic-resistant strains of existing diseases, for example tuberculosis. This can be accomplished by making sure that patients are treated completely for the illness and complete their treatment regimen rather than stopping treatment because the symptoms diminish. Not only does the disease have a possibility of surging up again, but it has a high chance of being resistant to the antibiotics that were used to treat it the first time. Also, quarantining such a patient is a must. Antibiotics are not being developed fast enough to cope with the increases in antibiotic-resistant diseases. Some officials fear a future epidemic of mutated diseases that are antibiotic-resistant, and this fear can be dissolved by increasing pressure to improve the administration of, and cut down on the abuse of, antibiotics.
Nice post Virginia. I strongly agree with your response to lead poisoning in children. I wrote about the topic in my own blog. I also like what you had to say about the improvements in public health preparedness and response. That is such an essential role in making sure the US is safe and healthy. You never know what could happen.
ReplyDeleteGinny, this is a great post. The public health preparedness and response achievement also resonated with me, and hopefully the improvements that have been made will lessen the devastation of future events. Lessening the prevalence of antibiotic-resistant bacteria is an important topic to tackle, and it is interesting that you brought it up because it is an issue that is overlooked. You bring up really good points on how we should combat the problem!
ReplyDeleteGinny-
ReplyDeleteGreat post! I think it is interesting that you linked your class last semester with the improvement in leah poisoning in children. I was unaware of the scale of this problem in Baltimore so this was really interesting to me. I am glad that we have been able to reduce this problem. I also wrote in my blog about the improvement in preparedness. I think this is such a crucial achievement for our public health system. If our country is more prepared and ready, we will definitely see more success when the next disaster hits.
-Kelley Hussey
Ginny,
ReplyDeleteI enjoyed reading your post. I agree with you that it would be great to see the issue of antibiotic resistance addressed, but how would you pratically go about ensuring that all the patients take the full course of antibiotics? As a pediatrician, I counsel the parents of my patients (and my patients, for the older ones) to take the entire course of their antibiotics but there is no way for me to ensure that they followed through. In TB treatment, they utilized the DOT method (directly observed therapy) where a provider (nurses, doctors, volunteers, community health worker, etc.) watched the patient take the medication. With antibiotics, however, there are way too many people taking it so there is no way to directly oversee that the patient takes it. If you could think of innovative way to ensure that patients take full course of their antibiotics, I'm sure you'll make headlines. :)
Here are some of my thoughts on the assignment: The article describes ten greatest public health achievements made in the United States during the decade between 2000 and 2010. The achievements mentioned includes advances in vaccine-preventable diseases, improvements that helped prevent and control infectious diseases, tightening of tobacco control, reduction in infants born with neural tube defects and other improvements in maternal and infant health, motor vehicle safety, CVD prevention, and cancer prevention among others. It is interesting that many of these achievements center on prevention as key. Also, it’s interesting that public health preparedness and response was included as one of the key achievements. We certainly learned our lesson—albeit painfully—about the need for better preparedness and response in public health emergencies.
Of the ten achievements discussed, childhood lead poisoning prevention and vaccine-preventable diseases particularly resonated with me because as a pediatrician, these are issues I deal with on a regular basis. We administer vaccines without much thought but when I think about all the potential illnesses we are able to avoid as a result of the vaccines, I am ever grateful to the scientists who helped develop these vaccines. The issue of vaccines also personally affects me in that I do quite a lot of international travel and am thoroughly vaccinated against terrible diseases such as typhoid, yellow fever, diphtheria, Hepatitis B, etc. I am grateful that that I can avoid these illnesses through vaccination. As for lead poisoning, I still see some children with elevated lead levels in Baltimore City when I do routine lead screening. It’s a reminder of how our actions in the past can have repercussions in the present and future. We should be mindful of how our choices today will determine the health of future populations.
In the next list of Greatest Public Health Achievements, I would like to see expansion of insurance coverage (i.e. improved access to healthcare) listed as one of the achievement. It is terrible that 50 million Americans (17% of the population) are uninsured and cannot access regular healthcare. Without access to primary care and prevention measures, the uninsured end up “growing” diseases and by the time they come to medical attention, it is often too late to reverse the course. In a country boasting of freedom and prosperity, it’s a shame that we cannot even guarantee basic healthcare to our citizens. Quite a number of people I know do not have insurance and often earn “enough” money which disqualifies them from need-based insurance policies such as Medicaid. The solution lies in our government taking responsibility and enacting universal healthcare beyond what the ACA provides.