By Deborah Hagar, MBA
Public Health is defined as - “the organized efforts on the part of society to reduce disease and premature death, and the disability and discomfort produced by disease and other factors, such as injury or environmental hazards. Public health is also a branch of preventive medicine, a medical specialty with a specialization in public health.” - Slee’s Health Care Terms, Healthy Communities Edition.
With this background and the renewed perspective on the rising costs of health care it is time to revisit the definition, role, and benefits to society of public health. With a new vision of what public health can offer, we can renew our commitment to doing a better job of managing health for members of the community and reduce the rising cost of illness.
The Problem: The health care system is reaching the breaking point in funding illness. Our resources are increasingly being consumed by the growing costs associated with ill health. Statistics confirm that only 20 percent of the population accounts for 60 percent of state health costs. Furthermore, one-third of all health spending is focused on half of the population, with 38 percent of the population having one or more chronic health conditions, and more than half have multiple chronic conditions. The average cost of medical services for a healthy individual is $2,400 per year. The average cost of an adult with a chronic medical condition is $4,800 per year, compounded for multiple conditions. Chronic diseases caused approximately 60 percent deaths worldwide in 2005, with projections that death from chronic disease will increase by 17 percent over the next 10 years.
The four most common chronic conditions in California are: hypertension, heart disease, asthma, and diabetes. This impacts 14 million adults in California. Nearly 1.5 million children have asthma. Obesity adds to the cost of health care, with one obese person costing the equivalent of three non-obese individuals.
What is the Role of Public Health: Health is the glue for any society and its members to be able to live their lives free from the limitations of illness and disease. It further protects personal assets from the financial burden incurred from the high cost of medical services.
Society pays for the cost of illness through taxes, uncompensated care, use of emergency departments for chronic illness, increased cost to business, and the social cost to families and care givers in caring for those in poor health.
The Solution: These demands on society require a renewed emphasis on public health and its potential value. Public health must be viewed as more than just a social welfare program for a limited at-risk population. Public health must be recognized as a critical module in preventing disease and building health for all citizens. We must re-evaluate the limitations we create with inadequate funding and the secondary role we give health. A foundation built on communities with a public engaged in managing their health and building healthy lifestyles pays great dividends to individuals, business, and government. The models exist, through programs such as Healthy People and other successful public endeavors, to educate the public and deliver services that assist in preventing illness, injury, and disease.
We need a renewed focus to re-examine funding to establish public health as an investment in our communities. A new emphasis on investing in health, with new public/private partnerships, is needed. A proactive approach is the best protection against the growing cost of illness.
Healthy communities attract businesses and provide a desirable living location for people to live and work and raise their families. Healthy communities share in the dividends. They provide effective education for a population that is able to learn. They provide a healthy workforce that is productive and contributes to the success of local businesses. They provide a desirable community in which to enjoy the retirement years. And most importantly they address the needs of the disabled, the frail, and the elderly in providing care and comfort.
How We Get There: Are healthy communities a myth? No. Are they feasible in today’s economy? Yes. They are the only way we can afford to continue as a society without rationing care and further dividing the haves from the have-nots.
We cannot afford to ignore this issue. The better alternative, health, is proven to assist us in leading happier lives with more dollars to spend on things of value to us and to our families. Public health is an investment we cannot afford to make.
Deborah Hagar, MBA, Coalition for Quality Affordable Health Care, San Bernardino, can be contacted at (909) 890-4050.