The Public Health sector represents a greater need to drive innovation for research to enhance the healthcare systems and create awareness. In this paper, we are going to illustrate the challenges faced in Public Health, their determinants in different countries, the strengths and limitations of these services under the Public Health sector, and the steps that practitioners would need to take to enhance access to these services.
The Centre for Disease Control and Prevention states that the most common challenges facing public health both nationally and internationally including alcohol-related harms like accidents, diseases like HIV, teen pregnancies, nutrition, and obesity not forgetting drug abuse.
The greatest public health issue facing both the United States and other countries currently is the Outbreak of Diseases. The health of each individual can be affected by climatic changes and even one’s hygienic standards. In 2014, the Ebola virus broke out across the African state affecting majorly Nigeria. Another outbreak was the spread of H1N1 influenza in the United States and now the Corona Virus pandemic that began in 2019 from China.
Globally, the number of deaths caused by non-communicable diseases like heart diseases is on the rise while those caused by communicable diseases like tuberculosis are decreasing. However, some countries face disparity in healthcare and this analysis can shift depending on one’s location. Therefore, such countries must face the burden of preventing and controlling diseases while they create awareness among different communities.
It is important to note that an outbreak of disease is uncontainable in countries that are experiencing a crisis or any form of conflict (Abimola S. 2015). Such attacks can easily affect medical practitioners and destroy medical facilities plus equipment hence limiting access to health provision in a given area. According to Aljazeera, in 2018, Doctors Without Borders suspended their medical activities in Nigeria after two aid workers were killed by the BokoHaram in a place called Rann.
Implementing justice in Public Health will help make health care accessible to everyone regardless of their differences. With the general growth in diseases like cancer, mental health, injuries, and even drug abuse; the gap in health provision is increasing.
Even though it is crucial that Organizations like WHO should provide medical practitioners who will provide quality healthcare, the government is also needed to ensure these conflicts are contained.
Social Determinants in Outbreak of Diseases
Disease outbreaks that are determined by social factors can vary from one’s ethnicity to their education level, to their healthcare services and even policies put in school or the workplace.
In the United States;
Medical Practitioners prefer to focus on adjustable factors like poor access vaccination and healthcare, social policies, and lastly individual-neighborhood level factors.
Poor access Vaccination and Healthcare
To prevent the spread of diseases, it is often recommended that patients access healthcare immediately and acquire vaccination. However, like most countries, the United States is also subjected to inequalities. People from disadvantaged communities are considered more prone to infections through institutionalized or structural barriers. These barriers make it difficult for these people to utilize pharmaceutical interventions like isolation and treatments especially when the medications are insufficient. As a result, people from this population can easily experience abrupt deaths.
A review by Lindley states that Whites can easily access vaccination compared to Black Americans and the Latino community. These differences persist even among those individuals who have a better education than others.
School and Workplace Policies
Disease transmission can easily be spread since these facilities provide free vaccination, sick leaves, and even school closures. Incase vaccination becomes scarce, organizations are requested to implement social distancing as a scheme to reduce transmission of the disease within the workplace. In this regard, workers were given seven days of sick leave per year to care for themselves and their loved ones. However, this act, commonly known as the Healthy Families Act has not been implemented since most employees from disadvantaged communities still have no access to these benefits.
Neighborhood and Individual-Level Factors
The research that was conducted in 1918 about the Influenza crisis shows that people from marginalized communities in the United States experience high death and infection rates.
Exposure to the neighborhood-level disadvantages like unemployment, violence, and vandalism may lead to stress factors that heighten infections and illness. Individuals living in such neighborhoods and those who abuse drugs can easily develop detrimental behaviors that lead to the spread of infections
In Nigeria,
A proper understanding of the social determinants of the spread of diseases like Ebola in Nigeria leads to a deliberate shift in efforts to contain the spread of these diseases. To understand the transmission in Africa, social determinants have been categorized into Environmental Factors, Social Factors, and Behavioral Practices
Behavioral and cultural practices
These practices tend to occur at home, in the community, and also in the hospital setting. The scientific approaches of contending with the spread of this highly communicable ailments are normally ideal. However, the most recent trends in dealing with these outbreaks in Africa have proved that using only the scientific methods, without considering other contextual factors, is not enough to control the spread of this disease. Therefore, Nigerian communities tend to seek traditional healers. Even though most people rely on traditional medicine, this was associated with unavailability to gain access to health facilities
Environmental Factors
The situation in most villages presents worst-case scenarios. Settlements are not well planned and most developed countries have created slums which are not conducive for human settlement
Social environment
Some social conditions like poverty, growth, poor infrastructure enhance human contacts. These circumstances repressed the formation of adequate public health facilities
Public Health Services
These services include Assessment Policy Development and Assurance.
Assessment
Monitor and evaluate health status to identify community health problems.
Through this assessment, practitioners will ensure that tools are properly utilized, public health records are well managed and health records are in good condition.
Organizations can implement this by creating a community health profile and disease reporting system. For instance, the Los Angeles Department of Public Health completes a health survey every two to four years to obtain population-based data.
Diagnose and investigate health problems and health hazards in the community.
To appropriately allocate public health resources, this process ensures that the public health labs offer quick screening, investigations of disease outbreaks, and patterns of disease are conducted and individuals are given access to testing and screening. For example, cardiovascular disease is monitored through one’s blood pressure and body mass index.
Practitioners must therefore prepare and be readily available to combat natural disasters and handle mass casualties
Policy development
Inform, educate, and empower people about health issues.
Once the health priorities have been established, educational accomplishments that promote improved health should be circulated. This process will help in creating programs, availing health information, and providing educational resources. A good example is the Eat Less, Weigh Less campaign executed by the Los Angeles County Department of Public Health. This aims to increase awareness by using advertisements on billboards and social media.
It is also important to establish health education and health promotion program partnerships with organizations in the community, such as schools and churches.
Mobilize community partnerships to identify and solve health problems.
This process helps in building coalitions to utilize the available resources; assist partners and communities to solve health problems and to facilitate partnerships that will undertake defined health improvement projects.
It also helps in identifying potential stakeholders who will contribute and benefit from the public health activities. For example, organizations involved in urban planning may be influential in improving the health of its residents by increasing the duties within the community and increasing the number of bike trails in a neighborhood.
Develop policies and plans that support individual and community health efforts.
Policies can be effective in modifying human behavior and reducing negative health outcomes by aligning the resources and strategies for community health effort, developing policies that will guide the practice of public health, and creating strategies that will guide the community’s health development. For example, to tackle obesity and the increase in cardiovascular diseases, the New York City Board of Health banned the sale of sugary drinks like sodas and any other sugary drink than are larger than 16 ounces at streets and restaurants (Johnson and Finegood,2015).
Besides, laws can also reduce negative health outcomes. For example, the Dram Shop Liability Suit is a law that holds the owner of a restaurant or bar responsible for any injuries or deaths caused as a result of alcohol and if it was consumed at that specific premise.
Assurance
Enforce laws and regulations that protect and ensure public health and safety.
Individuals must observe the prevailing laws to ensure the general health and safety of the public. This service helps practitioners educate and encourage both people and organizations about the enacted laws to improve compliance. Secondly, practitioners can enforce actions that safeguard the health and safety of the public. It also helps them in reviewing, revising, and evaluating the laws and regulations put in. For example, enforcing laws that prohibit the sale of alcoholic and tobacco products to minors.
They can also link people to desirable personal health services and assure them of the provision of these services in case they become unavailable.
This process helps people avoid inappropriate medical costs and prevent negative health issues. Locally, its mechanisms include: finding communities that encounter barriers when accessing health services, assuring people from these populations of the provision of best health services, and implementing interventions that address these barriers.
At the government level, components of this service include: partnering with the public, the private, and the non-profit sectors to provide a coordinated system of health care; developing a continuous improvement process to assure the equitable distribution of resources for those in need of these services; gang access to the available state health services. The National HIV AIDS Strategy adopts this service as a measure to achieve an increase in access to health care for people living with HIV.
Assure a competent public and personal health care workforce.
Health care workers and staff who are competent, are more likely to provide care and other services more effectively and efficiently compared to those who are not. Components of this service include: making sure that the workforce meets the health needs of the population, maintaining public health workforce standards through efficient licensing, adopting continuous quality improvement methods, and providing long-term education for public health members and.
In 2002 reports, the Institute of Medicine (IOM) recommended providing certificates after examinations as a way of ensuring minimum competence in public health. Online training strategies may be useful in providing long-term learning opportunities that many health workers and students need
Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
Given scarce resources, it is important to keep track of whether or not programs and policies end up producing intended outcomes. Components of this service include: assessing the effectiveness of services and programs delivered; providing policymakers with the information they need; and striving to improve the public health system’s capacity to well serve the population.
Cost-effectiveness analysis has been proposed as one possible strategy for informing policymakers on how best to allocate health care resources
Research for new insights and innovative solutions to health problems.
Through research, the health problems that individuals face can be appropriately addressed, given the evidence provided by such research efforts. Components of this service include: establishing a group of research institutions and those of higher learning to encourage more collaborative and cross-cutting effort, ensuring the public health systems are up to the capacity to perform timely health policy analyses
Benefits
The benefits of this type of assessment processes have been well documented by the CDC and other partners. This process helps practitioners:
Collect baseline data that will reflect on the performance of the public health system.
Recognize the strong points and weaknesses that can be addressed in terms of improvements by using a recognizable tool.
Improve communication and partnership by bringing partners together
Educate members about public health, its essential facilities, and the merger of activities.
Limitations
Despite the advantages, there are limitations related to these processes, and they can be categorized as tools used data collection methods and general results. These limitations include:
Several representatives will not show up for the process including those from the school system, business community, and the media.
The format to be used during assessment and its commitment level may prevent some participants from engaging in the process.
The time commitment may have prevented the ability of some participates to attend due to a lack of employer support and even conflicting priorities.
The tools to be used might be comprehensive and cumbersome
The scores are subject to biases and opinions of those who will participate in the process.
Although eccentric statements will be recorded, the majority vote will not reflect the viewpoint of many participants.
The results of the assessment will be based on a facilitated group process during a specific period. Secondly, Changes to the local public health system at all levels constantly occur.
RECOMMENDATIONS
To decrease the transmission of these infections, policies should focus on eliminating existing vaccination barriers and supporting reasonable social strategies. For example, to combat the harmful health behavior’s observed in disadvantaged neighborhoods, efforts should be aimed at increasing vaccination coverage, improving health behaviors, and addressing specific underlying health issues. Some nations are establishing programs that will address these issues. For example, Africa as a state has been implementing programs that will deal with violence prevention and road safety
According to DeSalvo(2017 ) Improving worldwide health can increase health in the United States and support national and global safety benefits by fostering diplomacy, political stability, and economic growth worldwide.
Investments placed for improving health in developing countries provide significant public health benefits within the United States. Many global health issues can directly or indirectly influence the health of the United States and also affect trade. Health agencies within the United States can use the strategies of states with better health outcomes than the United States to identify ways of improving the nation’s health care.
Even though countries are required to develop appropriate response teams that will help address these health concerns, all of these issues will require collaboration with other countries to protect and promote better health for all. To make this possible, countries must be willing to set aside 1% of their gross domestic product for primary health care services.
Reference
Johnston, L. M., & Finegood, D. T. (2015). Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector. Annual review of public health, 36, 255-271.
DeSalvo, K. B., Wang, Y. C., Harris, A., Auerbach, J., Koo, D., & O’Carroll, P. (2017). Peer-Reviewed: Public Health 3.0: A Call to Action for Public Health to Meet the Challenges of the 21st Century. Preventing chronic disease.
Omole, O., Welye, H., & Abimbola, S. (2015). Boko Haram insurgency: implications for public health. The Lancet, 385(9972), 941.
Krisberg, K. (2020). 10 Essential Public Health Services Under Review. American Journal of Public Health, 110(3), 263-263.