Environmental Health Holds the Keys to Public Health's Future
Date posted: Friday, June 5, 2020
Blog poster: Doug Farquhar, JD
One of the foremost paradigm changes that has occurred in public policy in the past 10 years is the enactment of the Patient Protection and Affordable Care Act, also known as the Affordable Care Act (ACA) or Obamacare.
Among its many provisions is the expansion of Medicaid. States that accept the expansion receive federal money to pay for a broader reach of Medicaid recipients. It also has made Medicaid the single largest cost to state governments, more than K-12 education, more than prisons. ACA is more than a noble gesture. It has made a healthy public essential to a state's bottom line.
With states paying for healthcare, public health becomes critical. And every disease not caused by genetics means that environmental factors might be the cause of those illnesses.
As stated by Michael Sparer, JD, Ph.D., chair of the department of health policy and management at the Mailman School of Public Health at Columbia University, in a recent op-ed in The New York Times, it has been the "nonmedical determinants of health, using regulatory authority to ensure working sewage systems, safer food, chlorinated water, cleaner streets, better workplace conditions, improved housing, and emergency preparedness. These interventions produced steep increases in life expectancy." (CDC 1900–2016 Life Expectancy Data | PDF)
It has been the environmental factors of public health—the improvements to sanitation, food safety, and the core determinants of environmental health—that have provided for the current high levels of life expectancy in this country.
The call for an overhaul of the nation's public health system cannot forget the environmental factors. Environmental health and improvements to basic environmental health services have led to people in this country being healthier than they ever have been. And it will be the continued efforts of environmental health that will ensure our population remains healthy.
Dr. Sparer concludes his op-ed by saying, "It will take strong national leadership, billions of dollars, and a 21st-century Marshall Plan to create the public health system we need."
As public health moves into the 21st century, it will be the expanded efforts of environmental health in areas of climate change, social determinants of health, urban planning, and biotech that will frame modern public health. For the nation's governments, the federal, state, local, and tribal governments that pay for the public health system, the efforts to improve the nation's health will demand a robust environmental health program.
Environmental health holds the keys—economically and programmatically—to public health's future.
About blog poster: Doug Farquhar is the Director of Government Affairs at the NEHA in Denver, Colorado.