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Health Officers Report Identifies Five Major Challenges Facing US Public Health

Stating that “Our nation’s public health capacity is functional, but fragile”, and “Health threats are increasing, not decreasing”, a report by the Association of State and Territorial Health Officials (ASTHO) has identified five priority issues facing health departments nationwide. They are:

1. Addressing the opioid crisis and preventing substance misuse and addiction. More than 60,000 deaths occurred in 2016 alone, and that represents more than 100 deaths every day. According to the report, “we will not treat our way out of this emergency” and “preventing addiction is the best way to end our nation’s current epidemic.”

2. Reducing illnesses and deaths from preventable chronic diseases. According to the report, “for every dollar, the United States spends 97 cents on healthcare delivery and 3 cents on prevention and public health.”

3. Preventing infectious disease outbreaks. The importance of infectious diseases is illustrated by the increases in rates of sexually transmitted diseases, healthcare associated infections, and other diseases such as hepatitis C which affects 2-4 million persons.

4. Managing public health emergencies. The report notes that 2017 was the costliest year on record for weather-related disasters, and there is an ever evolving list of public health threats that must be addressed to manage the consequences of national emergencies to help save lives. Funding for preparedness related work has declined almost one-third since 2002 for these activities.

5. Protecting drinking water from environmental health threats. This is about maintaining a water supply that is among the safest in the world. Resources are needed to bolster the protection of these supplies from threats from multiple sources.

According to Michael Fraser, ASTHO executive director, “the top five issues identified by state and territorial health officers represent some of today’s greatest threats to public health nationwide. However, if we act now, they also present tremendous opportunities to protect and promote health.”

Invisible Public Health Benefits

The ASTHO report highlights many public health activities whose benefits often go unappreciated by Americans because the targeted diseases are prevented from occurring in the first place. These “invisible benefits” include those associated with screening all newborn babies to identify life-threatening genetic illnesses, immunizations against vaccine-preventable diseases, clean water protecting against water-borne diseases (safe water), prevention of food-borne illnesses (safe foods), and public health laws such as those to prevent injuries of many kinds and those which create smoke-free workplaces.

To access the report, visit:


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