Coronavirus

A Post-COVID-19 World: Putting The “Public” Into Public Health

In recent days and weeks, you likely have heard or used the phrase, “We are all in this together.” This lovely sentiment of solidarity in the face of uncertainty is one way to give ourselves something to hang onto — a bonding of our human tribe during a profound moment in human history; a moment when we face the reality that yes, we really are all in this together.
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In recent days and weeks, you likely have heard or used the phrase, “We are all in this together.” This lovely sentiment of solidarity in the face of uncertainty is one way to give ourselves something to hang onto — a bonding of our human tribe during a profound moment in human history; a moment when we face the reality that yes, we really are all in this together.  

Of course, with the COVID-19 pandemic, we have been told to go home, social distance and stay away from each other. Curious, isn’t it?  

“This is probably the first time in our lives we have to come together by staying apart,” observed Ed Hardin, sports columnist for the Greensboro News & Record, in the wake of the NCAA’s cancellation of the March Madness tournament. The takeaway? We need to cooperate and work together for our mutual benefit — for your health, for your family’s health and for our nation’s health. 

But the COVID-19 pandemic also is teaching us that it’s time to put the “public” into Public Health. By this, we mean you. Working together, we have a better chance of shaping social conditions that help individuals and whole communities to be healthy.  

The common enemy scenario throughout human history always has been a great momentary social bonding agent. As a nation, we bonded together to support our allies during both World War I and World War II. As Americans, we felt a dormant but powerful connection following 9/11.

Fortunately, our capacity for communal connection also permeates throughout society in moments of great achievement. Remember Neil Armstrong taking the first step on the moon? For those watching, we all remember in collective wonder as images from so far away beamed into our living rooms. 

But this moment in human history is unique — a potential once-in-a-generation, game-changing moment. One that transcends differences and ties states, nations and distal communities in a global struggle to understand and confront something smaller than our eye can see.  

Yet, one wonders whether this bonding might fizzle once our common threat has run its course. After returning to our daily lives, will we hang onto this bonding thought of being in something together?   

We can achieve great things when we are attuned to doing something together. Those of us in public health have always felt we are in this together. We routinely analyze the diseases that plague us, the determinants that impact our health and the social dysfunction that ails our communities. We study and assess the ways individuals stay healthy or fall prey to whatever health threat is around the next corner. We do this in order to isolate strategies that might, with some effort, tweak our collective path towards a healthier society. That is the nature of what we do.

The challenge of discussing the “health system” in America is that the conversation is limited largely in people’s minds to the delivery of healthcare services. And while the delivery of those services is important, these systems typically are only utilized once someone becomes sick and requires medical intervention. Some argue the healthcare system should be rebranded the “sickcare system” to accurately reflect its primary benefit of providing powerful services to those in need of healing and lifesaving. 

The public health community routinely refers to health as a result of the “conditions where we live, learn, work and play.” This covers a lot of ground, we know! But, we feel our nation’s conversation about health should include a collective understanding and effort to promote healthy social and physical environments rather than solely the treatment of ill health. A primary aim of public health is to keep you as healthy as possible, so we do not have to enter the sickcare system. Nice idea, right?  

Historically, our nation has not fully supported the idea of public health and the powerful potential it provides. According to a recent report by Trust for America’s Health, “The impact of chronic underfunding on America’s public health system: Trends, Risks, and Recommendations, 2020,” less than 3 percent of the estimated $3.6 trillion the United States spends on health is directed toward public health and prevention. As a proportion of total healthcare spending, the amount spent on public health has been decreasing annually since 2000.  

Waiting to spend our nation’s resources once things get bad has never been a good deal, and the time is right to examine whether a little bit of health re-prioritization might be a good idea relative to public health and the healthy society we all value. 

In the post-COVID-19 world, we are still all in this together. Welcome to the public health team.  

Dr. Robert Strack

Dr. Robert Strack is a professor and chair of the Public Health Education program at University of North Carolina at Greensboro.

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