The U.S., along with the rest of the world, faces many public health challenges. These include disease outbreaks, vaccine access and distribution, a growing number of people coping with various chronic illnesses, and substance abuse epidemics. The nation’s public health infrastructure is woefully and consistently underfunded, compounding the severity of these issues. According to Trust for America’s Health, a nonprofit that advocates for public health research and policy, the U.S. spent $3.8 trillion on health care in 2019, but less than 3% of that was directed toward public health and prevention. This has left public health departments understaffed and lacking the resources to effectively combat these challenges. As a result, the public health system has struggled to control the COVID-19 pandemic. Yet the rise of multiple public health trends — such as the increasingly widespread use of telehealth and efforts to address racial and ethnic disparities in health care — can help address the many other challenges ahead.
A well-trained and well-educated workforce is essential to improving public health. A Master of Public Health (MPH) program can help students identify and understand the field’s most vital trends and prepare them for a rewarding career.
Health Trends in the U.S.
Even after the U.S. has moved on from the COVID-19 pandemic, the medical community will still have to contend with an array of other issues. Looking ahead to the next decade and beyond, a handful of health trends in the U.S. are likely to dominate the discussion around public health.
Disease Spread and Vaccine Distribution
The COVID-19 pandemic is the latest and starkest reminder of the threat of communicable diseases. Hundreds of thousands of people have died from COVID-19 in the U.S., . Meanwhile, tens of thousands die each year from influenza and other infectious diseases. The technological tools that are used to identify and mitigate the spread of disease already exist — they just need to be activated. Electronic health record (EHR) technology could allow public health officials to more efficiently identify potential outbreaks by monitoring symptom reporting in physicians’ notes. Detecting an outbreak early makes quarantining and contact tracing measures more effective in minimizing spread, which applies to not only COVID-19 but also seasonal influenza, foodborne illness, and other disease outbreaks. The fight against COVID-19 has also underscored the need for improved vaccine access and distribution. At the end of 2021, only around 60% of the U.S. population was fully vaccinated against COVID-19 and less than 50% had received a flu vaccine, according to the Centers for Disease Control and Prevention (CDC). Ensuring that more people have access to vaccines, along with combating vaccine misinformation, is essential to minimizing the spread of infectious diseases.
Chronic Disease Prevention and Management
According to the CDC, the percentage of adults with at least one chronic disease is around 60%, with roughly 40% of adults having two or more. Some of the most common chronic diseases are cancer, diabetes, Alzheimer’s disease, and heart disease. Collectively, these diseases are the country’s leading causes of death and disability and are the primary contributors to the nearly $4 trillion the U.S. spends on health care each year. Promoting the use of and access to preventive services, such as cancer screenings and blood pressure checks, is essential to improving the quality of life for millions of Americans. Providing education and guidance for the lifestyle choices that increase the risk of chronic illness — such as tobacco use, poor nutrition, and lack of exercise — is also critical.
Another public health trend is the field’s increased focus on behavioral health issues, such as mental illness and substance abuse. According to the National Alliance on Mental Illness (NAMI), roughly 20% of adults experience mental illness and about 5% cope with serious mental illness. Those numbers rose during the pandemic, with about 40% of adults reporting mental health or substance abuse struggles, according to a CDC survey. Mental health struggles are also associated with other health issues, including an increased risk of chronic diseases like diabetes or cancer. NAMI estimates that depression and anxiety disorders alone cost the global economy approximately $1 trillion a year in lost productivity. Public health campaigns focused on destigmatizing mental health concerns and connecting people to mental health resources are crucial. Officials can also leverage existing infrastructure — such as rural health clinics, primary care offices, and schools — to expand mental health screening and education. A public health approach to substance abuse could also be beneficial. According to the CDC, drug overdose deaths surged by nearly 30% from April 2020 to April 2021, claiming more than 100,000 lives. Increased investments in prevention and treatment resources are critical, along with funding to target the underlying causes of substance abuse.
Trends in Public Health
Although the U.S. spends more on health care than other industrialized nations, it produces some of the worst outcomes in public health, according to The Commonwealth Fund.
- The U.S. has the lowest life expectancy and highest suicide rate compared with other high-income countries in the Organization for Economic Cooperation and Development (OECD), including Australia, Canada, France, Germany, and the U.K.
- The U.S. has the highest chronic disease burden and an obesity rate that’s double the OECD average.
- Compared with similar countries, the U.S. has some of the highest numbers of hospitalizations from preventable causes and the highest rate of avoidable deaths.
Inadequate funding for public health is a major reason that the U.S. is in many ways less healthy than its peers. The COVID-19 pandemic demonstrated the dangers of this lack of investment, with overburdened departments relying on antiquated technology and methods. While the Biden administration has expressed a willingness to boost funding for public health, several trends in public health indicate that the field is already making progress. Advances in technology, a renewed focus on prevention, and efforts to reduce health inequities are all integral to addressing the nation’s public health challenges.
Telehealth use surged at the start of the COVID-19 pandemic, accounting for roughly a third of all office and outpatient visits in April 2020, according to McKinsey & Company. Those numbers have since stabilized, but telehealth use is still many degrees higher than it was before the pandemic, and many employers now plan to offer more virtual care options as part of their benefits packages. Telehealth could potentially improve public health by making medical services more accessible to a wider patient population, especially medically underserved communities and residents of rural areas, who are more likely to have chronic health conditions. Converting in-person annual wellness visits into virtual visits is also more convenient for patients, increasing the likelihood that they’ll access care when they need it and take the necessary steps to manage their care. In addition to its health benefits, telehealth can reduce the overall cost of health care. Increased telehealth use can reduce the length of hospital stays and minimize unnecessary emergency room visits, which are typically very costly.
Other Forms of Technology
Besides telehealth, various technological tools have the potential to reshape public health.
- Wearable devices allow physicians and other medical professionals to monitor patients remotely and track health metrics like blood pressure and pulse rate. Remote monitoring makes it easier for patients and providers to manage chronic illnesses, particularly for older patients for whom an in-person visit may be challenging.
- Artificial intelligence (AI) and machine learning tools can analyze huge amounts of data to identify patterns. In an infectious disease outbreak, these technologies could be used to scan EHRs for symptom reporting. This can allow public health officials to identify outbreaks early on and implement the necessary measures to prevent spread.
- Underfunded public health departments regularly rely on antiquated technologies and methods, such as manual data entry and faxed forms, possibly resulting in flawed or delayed data. By leveraging technology such as EHRs and machine learning, public health professionals can share and gather vital information more quickly and respond to disease outbreaks and other crises more efficiently.
Addressing Health Disparities
Addressing the social determinants of health — such as race, economic stability, education, housing, and access to transportation — has long been a public health trend. These factors contribute to widespread health disparities and have a huge impact on wellness and life expectancy. For example, people who live in urban food deserts, where access to grocery stores that carry healthy foods is limited, are less likely to have good nutrition and are at greater risk for chronic health conditions like heart disease and diabetes. COVID-19 underscored the urgency of efforts to address these disparities, as the pandemic disproportionately impacted communities of color and other marginalized groups. Unless public health officials and other leaders commit to minimizing these disparities, the social determinants of health will continue to play a role in how certain communities grapple with the health impacts of infectious disease, climate change, and other challenges. Initiatives aimed at addressing the root causes of health disparities are crucial, along with increased funding to specifically target these issues. Policies that reduce poverty and improve access to housing, transportation, and education can help minimize the inequities stemming from the social determinants of health. Efforts to recognize and resolve implicit bias and structural racism in the health care system are equally important, including ensuring that health care workforces reflect the cultural and racial diversity of the communities they serve.
Preventive Health Services
Preventive services can help find diseases early, when treatment is more effective, or prevent it altogether. These services range from screenings for chronic conditions like cancer and heart disease to immunizations for infectious diseases, along with counseling for behavioral health issues. The positive impacts of this focus on prevention are far-reaching. There are significant cost savings associated with the use of preventive services, as they tend to reduce emergency room visits and hospital stays. They can also help minimize the harm that other health issues cause. For example, entering the pandemic, a majority of U.S. adults had at least one chronic condition — such as obesity or diabetes — which increased their risk of severe illness from COVID-19 and the likelihood of hospitalization and death. As the population continues to age, increasing the use of preventive services among older Americans is vital, yet only 25% of adults aged 50 to 64 and less than 50% of those aged 65 and over are up to date on many preventive services, according to the CDC. The rise of telehealth and other forms of virtual care can help boost the uptake of these potentially life-saving services.
Future Trends in Public Health
Many of the future trends in public health will be focused on addressing two primary concerns: the aging population of the U.S. and the corresponding increase in the rates of chronic disease and the health impacts of climate change.
An Aging Population
The growth in the population of older adults in the U.S. is unprecedented. According to the CDC, the number of Americans aged 65 and older is expected to reach 71 million by 2030 and 98 million by 2060, representing nearly 25% of the population. With age comes an increased risk of various chronic diseases, including heart disease, type 2 diabetes, arthritis, cancer, and dementia. Together, these diseases are the leading drivers of illness, disability, death, and health care costs in the nation. Alzheimer’s disease is the fifth-leading cause of death for adults 65 and older and, along with other forms of dementia, cost the U.S. health care system $290 billion in 2019, according to the CDC. Numerous measures can be taken to improve the health and quality of life of older Americans, such as the following:
- Increasing the use of clinical preventive services like cancer screenings and blood pressure checks. Telehealth use and other forms of virtual care can aid this.
- Increasing early assessment and diagnosis for those at risk for dementia and providing resources to assist with the prevention and management of other chronic illnesses.
- Promoting physical activity programs, which can reduce the risk of arthritis pain and even dementia.
Impact of Climate Change on Public Health
One of the nation’s most pressing public health issues is the impact of climate change. Extreme weather events, along with the less dramatic but more insidious effects of climate change, can lead to a host of adverse health impacts, making addressing climate change an important trend in public health. The potential health effects of climate change include the following:
- Cardiovascular disease
- Heat-related illness and death
- Injury and death from increased natural disasters like hurricanes and tornadoes
According to the World Health Organization (WHO), climate change is projected to cause approximately 250,000 additional deaths each year between 2030 and 2050. The hardest-hit populations will be those in low-income and medically underserved communities, as well as older individuals and those with chronic conditions. While efforts to use cleaner energy and reduce emissions are essential to overcome the climate crisis long term, public health officials and other leaders can undertake a number of more immediate measures to better understand and potentially mitigate the health impacts of climate change. These include the following:
- Gathering and analyzing data on environmental conditions, disease risks, and disease occurrence as it relates to climate change
- Identifying regions and populations that are at greatest risk for climate-related health threats, such as wildfires
- Educating the public on the health-related aspects of climate change, including risks and how to reduce them
- Developing and implementing preparedness and response plans for extreme weather events like heatwaves and floods
The Biden administration, meanwhile, has called for significant increases in funding for the CDC’s Climate and Health Program — which provides support to public health agencies to prepare for the health impacts of climate change — and climate and health research at the National Institutes of Health (NIH).
Mapping the Future of Public Health
The U.S. spends far more on health care than other industrialized nations, but collectively its citizens are less healthy compared with those countries. A renewed focus on public health is key to addressing the nation’s many public health challenges, from the spread of infectious disease and rising rates of chronic illness to the impacts of climate change. The emergence of a number of public health trends is instrumental in tackling these challenges: telehealth and other technological advancements that make health care more efficient and accessible; efforts to reduce health disparities and uproot bias and racism in the health care system; and a greater emphasis on mental health. These measures promise to improve the quality of life for millions of Americans, while driving down the cost of health care. Ohio University’s online MPH is helping prepare the next generation of public health leaders. The program curriculum can enhance your knowledge and skills and qualify you for various public health roles, including epidemiologist, environmental scientist, and medical and health services manager. Learn more about how the program can help you achieve your professional goals.