U.S. faces ‘health crisis’

Recent recommendations from an Institute of Medicine (IOM) report may have raised a lot of eyebrows, but to Mary Mincer Hansen, Ph.D., R.N., they’re no-brainers.

Chair and program director of DMU’s master of public health program and a member of the global health faculty, Hansen has served the past two years on the IOM Committee on Public Health Strategies to Improve Health, which was commissioned by the Robert Wood Johnson Foundation to examine three major topics that influence public health – measurement, laws and funding. In its latest report on the third topic, the 18-member committee recommended, among other actions, that federal spending on public health should be at least doubled from its current level of about $11.6 billion per year to approximately $24 billion.

The committee also proposed implementing a “transaction tax” on medical care services to generate these additional funds.

“Public health touches everyone’s life everyday, from ensuring clean water and safe food to adequate immunizations against infectious disease,” Hansen says. “Public health is also about the economic health of our country. It works to create an environment to help prevent chronic diseases that reduce individual productivity and increase the cost of health care for all of us.”

The IOM committee report states the U.S. Department of Health and Human Services should set goals for U.S. life expectancy and per-person health spending as a first step in achieving better health outcomes. Currently, the U.S. scores lower on many outcomes compared to other wealthy countries, despite spending far more than other nations on health care. Life expectancy in the U.S. ranks 49th among all nations. Infant mortality rates in America are higher than in many less affluent countries.

Hansen points to past campaigns that show the power of public health education, such as promotion of seat belt use and anti-tobacco programs. A report by the Centers for Disease Control and Prevention credits public health efforts for adding 25 years to Americans’ life expectancy during the 20th century. The battle for better public health is far from won, however.

“Some are saying now that because of obesity rates among children, we may experience a decrease in lifespan,” Hansen says. “With the current abysmal investment in public health, we have a health crisis in this country.”

“Some are saying now that because of obesity rates among children, we may experience a decrease in lifespan,” Hansen says. “With the current abysmal investment in public health, we have a health crisis in this country.”

Countering the crisis, she adds, will require new and greater funding to tackle the rising rates of diabetes, heart disease and other chronic diseases as well as to support efforts that enhance health, such as safe public parks, plentiful fruits and vegetables and access to preventive care.

“The future of our children and grandchildren is based on good public health,” she says.

While legislators reacted with “predictable concern” to the report’s recommendations, Hansen says she and her fellow committee members will continue to advocate for their implementation among policymakers, funders and consumers. “We continue to look for ways to share our information and catalyze action,” she adds.

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