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List of Public Health Issues Continues To Grow

No Consensus On Criteria For Framing An Issue As A Public Health Issue

In May 2014 we published an article about topics which were being presented as public health issues. It was surprising to see issues such as “All Season Tires” and “Hoarding” appear on the list. We offered a quiz for readers to determine which ones met their personal case definition for a public health issue.

Because of the popularity of this initial article, we are reprinting it here with additions to the list which have come to our attention more recently.

What makes calling an issue a public health issue so powerful? It appears that seeing social phenomena through the lens of public health offers benefits that many advocates seek.  One of our lead articles coming next month calling for the development of an “epidemiology of toxic speech” can be interpreted as yet another attempt to bestow the benefits of the public health approach on an unresolved social problem. What criteria must be fulfilled by a social phenomenon to be legitimately classified as a public health issue? We present in the table below some of the reasons enunciated by proponents for considering their issue a public health issue. We welcome reader comments what criteria should be fulfilled to adopt public problems as public health issues. Send your comments to



Reasons Cited

Gaming Addiction

  • Use of internet, computers, smartphones, and other electronic devices has dramatically increased over recent decades. While the increase is associated with clear benefits to users, health problems have been documented. In a number of countries, the problem has become a significant public health concern.

Legalization of marijuana

  • It’s a risk, even though less than tobacco or alcohol.
  •  Lawful age to purchase is too low at 18.
  • Drug impaired driving is a concern

Knife crime

  • Persistent levels of knife-related violence require a preventative program

Deportations of children

  • Increased occurrence of child patients with sleep and eating disorders, anxiety, depression, and stress which could lead to adult diseases as well.
  • Actions are cruel and inhumane.
  • Immigrant emotional and mental health is being affected


  • We are unleashing too many deadly zoonotic disease which are crossing the species barrier.
  • We need to recognize the close connection between human, animal, and environmental health. 
  • We need to fight unplanned epidemics and the anthropogenic threat of bio-warfare

Residential fires

  • Someone dies every 153 minutes and someone is injured every 30 minutes in a residential fire.


  • An increasingly prevalent presenting problem in sexual health clinics.
  • Skills and resources of public health not being applied to this problem

Elder Abuse

  • Problem expected to grow as population ages
  • The health consequences are serious


  • As prevalent now as in the 1960’s. Personal responsibility is ineffective.
  • Crucial role of both government and individuals to overcome it


  • Among the most profound influences on children

Child Mental Health

  • Need to improve the mental health of all  children, not just those with diagnoses

Bed bugs

  • A public health pest
  • Cause a variety of negative physical health, mental health, and economic consequences

Violence against women

  • Annual injuries and deaths are high enough to demand the type of active interventions and public policies that have been targeted at infectious diseases by public health agencies

Sex segregation in sports

  • Decreases women’s participation in sports and has implications for myriad health issues


  • Because of the numbers of people who may have long term impairments due to playing.

War on drugs

  • Drug use itself should be considered a disease not a crime

Hate crimes

  • Because they exact a toll on the health of those directly victimized and on the health of the entire community

Police violence

  • Because it impacts both physical and mental health. It can lead to injury and death.
  • It undermines both the sense of community and of personal well-being.
  • It is preventable.


  • Risk factors operate at all levels, individual, relationship, community, and society.
  • Public health policies are essential.
  • Public health framework is critical for understanding risk and protective factors operating at multiple levels.

Human trafficking

  • A public health lens informs who intervenes and engages in the fight against human trafficking.
  • A public health lens informs how we intervene. 
  • A public health lens informs what must be at stake to truly change the dynamics that enable human trafficking

Poor parenting

  • Adverse consequences persist down the generations and are a problem for society as well as individuals. May be a product of poverty and social exclusion rather than the fault of individual parents.


  • Need a population approach to improve health on a large scale.
  • Need a focus on prevention.
  • Need to address a wide range of risk and protective factors.
  • Need to better understand the science of suicide.
  • Public health values multi-disciplinary collaboration.


  • Psychological toll on black Americans causes stress related health issues causing them to die younger than white Americans.


  • Black Americans receive poorer health care
  • Research on Black Americans is under-funded.
  • People of color are underrepresented in clinical trials.
  • Poor Black Americans are being hit hardest by political resistance to implement the Affordable Care Act

Computer security

  • Individual action to protect yourself only gets you so far. You need a group response.


  • It is widespread in the US
  • It is a multifaceted form of maltreatment
  • It is linked to a wide range of health issues and can result in injury, distress, or death.
  • There are risk factors for bullying or being a victim of bullying
  • It may be preventable.

Alcohol Use

  • It is a causal factor in more than 200 diseases and injuries.
  • It causes deaths.
  • It is harmful for others besides the drinker


  • We pay little attention to the health of 10-19 year olds.
  • Almost all adolescent deaths are preventable
  • Mental health challenges are the overwhelming problem for adolescents
  • Teenagers need adequate consideration and a voice in public policy


  • They are preventable
  • We want to approach problems in the community as a whole and not focus on individuals
  • Want to focus on prevention not treatment
  • Want to use many solutions

Size of Soda Servings

  • Sodas are bad for health. If you are ill, your illness has consequences for others.
  • Public health measures make life healthier and safer for everyone.
  • Makes the default choice the healthier choice.
  • The intervention is broadly inclusive and democratic.


  • Unwanted childlessness causes significant sometimes life threatening consequences.
  • Prevalence is significant.
  • Often linked to preventable infections.
  • Recognition and treatment are neglected now.
  • Discipline of public health could contribute significantly to policy and programs


  • It is transmitted like a disease.

Gun Violence

  • The US has one of the highest rates of homicides in the developed world.
  • The US has an average of 88 gun deaths per day.
  • Every time a gun is used in self-defense, there are 4 accidental shootings, 7 criminal assaults or homicides, and 11 attempted or completed suicides.

Gun Violence

  • The National Rifle Association specifically targets the public health approach.
  • Promoting reasonable gun policies does not make public health professionals anti-gun

Marijuana Use Legalization

  • It produces second hand smoke
  • It leads to schizophrenia, especially in teen boys
  • Driving while high should be discouraged.

Achieving a “Good” Death

  • Public health addresses the distribution of limited resources.
  • We can achieve better care with lower costs by avoiding unwanted aggressive care.


  • It is the number one health public health issue of our time.
  • Unrelenting stress is linked to obesity, diabetes, depression, and suicide.
  • Teaching resilience can transform trauma.

HIV/AIDS in Fishing Communities

  • AIDS related illness and mortality are devastatingly high in some fishing communities.


  • A growing problem.
  • Epi studies suggest prevalence is 2-5 percent of the population.
  • It spreads pests and possible health dangers to the community.
  • Social service or other agencies have to use resources to clean houses people cannot afford to clean.

All Season Tires

  • Cold hardens the rubber in all season tires
  • They are unsafe in cold weather and dangerous in snow.
  • People are dying because of these tires.
  • Manufacturers are allowed to market tires as all season knowing they are unsuitable in cold weather

Childhood Obesity

  • It has a significant long term health impact
  • We do not have universally accepted definitions

Adult Obesity

  • We need to prevent it before it happens.
  • We need to create lasting change by making the healthy choices the easiest choices.

Child Labor

  • It is a global practice
  • It has many negative outcomes

Active (non-motorized) transportation

  • Everyone travels.
  • Transportation systems impact health.
  • Health should be considered in transportation and land use planning and decision making
  • It can produce health benefits and curb health care spending

Online Pornography

  • It is harmful in many ways—preventing healthy sexuality, disempowering women, leading to sexual violence and non-consensual sex.
  • It is so widespread as to be considered a crisis
  • If CDC got interested, we could have success in the way we had success with cigarette smoking

Climate Change

  • Rebranding this issue as a health issue rather than an environmental or national security issue might have more resonance for the average citizen.
  • It fosters a more emotionally compelling response since it focuses on the immediate implications a warmer climate could have on people’s lives. It provides a sense of hope that problems can be addressed and avoided.
  • Invoking health helps to bypass the political quagmire.
  • Doctors can have a potential impact scientists may not have because they can transcend political differences and we really care about what they say.
  • It can change the type of dialogue people have about climate change.

Gang Violence

  • It has a distressing impact on individuals, families, and communities.
  • The wider social-economic costs can be equally damaging.
  • It provides communities with the opportunity to rethink how services for young people are delivered and how public health funding can be used in a more flexible way.

As noted in our 2014 issue, a question posted on Researchgate resulted in the following criteria being offered for what makes an issue a public health issue.  Read these criteria and see if you would add or subtract from this list of criteria. Send your comment to

1.   The concept of preventability—there are conceivable ways to prevent the phenomenon.

2.   High prevalence of a risk factor or disease.

3.   A rapid increase in incidence and prevalence.

4.   Cost of the disease

5.   Burden of disease

6.   Has the capability of affecting the population as a whole

7.   Will require group action to solve.

8.   Ability to recognize the problem unhindered by obstacles posed by culture, politics, lack of resources, or lack of effective measures. This set of criteria effectively requires that a phenomenon must be seen as culturally appropriate, politically acceptable, technically feasible, and financially possible in order to be or become a true “public health issue”. 

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