The Public Health Landscape – At Home and Abroad

Public health has come a long way in the past few centuries and decades. Scientists, health care pros, and government officials have worked together to raise awareness of health concerns and public health initiatives. Today, national and international organizations are making a clear impact on health at home and abroad, improving the lives of all citizens.

To learn more, check out the infographic below created by the Regis College’s Online Master of Public Health program.

Public Health’s Early Beginnings

The 19th century set the stage for rapid advancements in the areas of sanitation, personal hygiene, and mental health.

The Great Sanitary Awakening
During the 19th century, the scientific community discovered that unsanitary conditions caused disease and the proliferation of illness. Because of this, cleanliness became viewed as physically and morally essential. Protecting public health also became a vital social responsibility as keeping public spaces clean replaced outbreak control via quarantine.

Public Health Responsibility
Disease was seen as the unfortunate fate of the poor and immoral before the 19th century, as wealthy citizens could “escape” outbreak by retreating to their country estates. As the 19th century progressed, urban environs showed escape was no longer an option. This caused people to realize health threats were constant and a societal problem, and not something that could be ignored or chalked up to individual shortcomings. Mental illness, or insanity, came to be viewed as partly a societal failing.

Edwin Chadwick and Dorothea Dix
Edwin Chadwick and Dorothea Dix were key players in the 19th century’s public health paradigm shift. As secretary of the Poor Law Commission and a London-based lawyer, Chadwick’s research of the London working class in 1838 led to “the sanitary idea,” a proposal that included sewage systems and people required to oversee national and local sanitary conditions. Dix, meanwhile, led the movement to expose the inhumane treatment of the mentally ill, work that led to the creation of 32 public institutions for mental health care and reforms that made the state responsible for the care of mental health individuals.

Public Health at Home

Today, public health officials are facing increasingly complex challenges impacting the nation.

Health Crises: The Opioid Crisis
In 2016 and 2017, about 130 people died daily due to opioid-related drug overdoses. 11.4 million individuals misused prescription opioids during that time span, which also featured an estimated 2.1 million people with an opioid disorder. According to the National Institute on Drug Abuse, the U.S. Department of Health and Human Services is addressing the crisis through tactics like improving access to treatment and recovery services, promoting the use of overdose-reversing drugs, and advancing better practices for pain management.

Suicide
In 2016, nearly 45,000 Americans died by suicide, making it the 10th-leading cause of death in the U.S. By comparison, there were 19,362 homicides that same year. Suicide was the second-leading cause of death among individuals ages 10 – 34, and the fourth leading cause of death among individuals ages 45 – 54. To combat this, American Psychological Association president Jessica Henderson Daniel, PhD, has called for a public health approach focused on increasing access to mental health screenings, increasing insurance coverage for mental health treatment and prevention services, and funding for evidence-based treatment.

The Role of the CDC
The CDC responded to the opioid crises by issuing the CDC Guideline for Prescribing Opioids for Chronic Pain to educate primary care physicians prescribing opioids to patients 18 and older suffering from chronic pain. The organization also responded to rising suicide rates by issuing Preventing Suicide: A Technical Package of Policy, Programs, and Practices to provide an overview of strategies designed to help states and communities improve their suicide prevention activities.

The International Public Health Landscape

Though the developed world has moved on to more complex public concerns, developing nations are still working on providing their citizens basic needs, such as clean water and sanitation.

Health Crises: Sanitation
The World Health Organization (WHO) states 2.3 billion people don’t have access to basic sanitation facilities. They also report that poor or inadequate sanitation causes around 280,000 diarrheal deaths annually. WHO combats this by publishing reports and guidelines to promote effective risk assessment and management practices addressing sanitation. WHO also partners with UNICEF and other NGOs to reach global sanitation targets. UNICEF addresses global sanitation and the water access crises by forming water, sanitation, and hygiene (WASH) teams to work in more than 100 countries, helping them improve sanitation services and promote basic hygiene practices.

Access to Clean Water
In 2015, 844 million people – roughly 3 in 10 – didn’t have access to a safely managed drinking water service. Furthermore, almost 159 million people relied on rivers, lakes, and other surface water sources. The Global Water and Sanitation Initiative, led by the Federation of Red cross and Red Crescent Societies, combats this issue directly. Thus far, they’ve helped 15 million people gain access to water and sanitation services and plans to reach another 15 million people by 2025.

International health organizations have blurred the borders that have for so long isolated individuals impacted by public health crises. Both in the U.S. and around the world, concerned citizens and public health professionals are making strides to reach individuals of all cultures, ethnicities, and social classes. With a master’s degree in public health, graduates will be better equipped to pursue a challenging yet deeply rewarding career reaching remote parts of the globe and local communities at home.