Three public health problems facing our world today

When it comes to public health problems, there is no doubt that COVID-19 is top of mind for most people. While it is certainly a priority today, there are plenty of other issues that existed well before the onset of the 2020 pandemic and have been exacerbated by the disease.

In this article, I am breaking down three topics of particular global importance from a public health perspective.

Three of the most pressing public health issues in 2023

This is nowhere near a comprehensive list, but the following public health problems are worth spreading awareness about.

1. Infectious disease, the importance of vaccination and vaccine misinformation

As an infectious disease and public health specialist, I have dedicated much of my professional life to studying and working to prevent the spread of communicable illnesses. Well before the onset of COVID-19 things like MRSA (methicillin resistant Staphylococcus aureus) and other highly antibiotic-resistant microorganisms, influenza, hepatitis, Ebola virus, malaria, tuberculosis and Zika virus presented big challenges on a national and global scale.

But the global COVID-19 pandemic has permanently altered how people think about disease, immunizations, and public health as a whole. Never before was so much information made available to the public from the public health infrastructure.

It is my firm opinion that the two most important public health developments in history are the availability of clean water and the creation of vaccines. Entire generations of children got to live to be adults or avoid long-term disability thanks to immunization programs that eradicated or nearly wiped out smallpox, measles, polio, hepatitis B, Hemophilis influenzae B and more.

And yet, in 2023, despite the nearly 700 million doses of COVID-19 vaccines (a full series consists of at least two injections, but in most cases up to five) administered to Americans, with low rates of severe side effects, we are seeing a rise in distrust of all vaccines. The number of individuals getting COVID-19 boosters, especially the bivalent boosters, has dropped significantly. This is largely due to the unprecedented disinformation campaigns on social media.

This increase in vaccine hesitancy poses one of the biggest public health communication challenges in the country. No vaccine is perfect; with most vaccines there are short-term side effects and rare adverse events that providers should discuss with patients. Like the flu shot, the COVID-19 vaccine is exceedingly safe and excels at protecting you against severe symptoms, hospitalization and death. In fact, data from the Centers for Disease Control and Prevention (CDC) shows that unvaccinated people who contract the virus are 14 times more likely to die when compared to those who are up to date on their COVID-19 vaccinations (including the bivalent booster dose).

But vaccination doesn’t necessarily prevent you from acquiring the disease in the first place – that’s where social distancing, masking and testing come in. An even bigger concern is that this distrust of vaccination is beginning to diminish confidence in other vaccines. Outbreaks of polio and measles are being seen worldwide, including some areas where those diseases were previously eradicated.

My own older brother developed measles–induced encephalitis that resulted in lifelong neurologic disability well before a measles vaccine was available. This demonstrates the consequences of not getting vaccinated for this highly transmissible and potentially deadly disease.

It is clear to public health experts and health care providers that the pros of vaccines vastly outweigh the cons. Right now, our priority should be producing public health communication campaigns that are transparent, convincing and backed by evidence.

2.    Climate change

Regardless of whether you believe that climate change is caused by human activity or not, the fact is that the Earth is getting warmer every year. It is hard to overstate the far-reaching effects that this has on every facet of life on this planet.

To list just a few examples:

• Unpredictable weather patterns, higher average temperatures and more frequent weather events like floods, fires, freezes and droughts
• Physical and emotional trauma caused by extreme and violent weather events
• Reduced access to essential services (e.g., gas, electricity, water, health care, transportation) due to infrastructure damage
• The range of tropical mosquito and tick-borne pathogens like Dengue Fever, Zika virus, West Nile virus and Malaria expanding into North America, Europe and Asia
• Increase in houselessness for low-income renters who get priced out of formerly undesirable neighborhoods by wealthier people fleeing affected areas
• More displaced people exacerbating the world refugee crisis

The Infectious Disease Society Association (IDSA) recognizes climate change and its adverse health impacts as a public health emergency in the United States and around the world. While it may not be possible to reverse the damage already done, there is still time to reduce and halt production of greenhouse gases responsible for global warming.

It will take a coordinated effort from regular people, climate scientists and U.S. and international policymakers to drive progress forward. Public health departments, agencies and professionals can spread education and support interventions to promote a safer environment and reduce climate change.

3.    Disparities of care

The third public health problem I would like to address is disparity of care – both stateside and abroad. A health disparity can be defined as:

“… a particular type of health difference that is closely linked with economic, social, or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, age, or mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.” (Healthy People, 2020)

In the United States, poor, low-income and working-class people have less access to health care, are underinsured and suffer worse outcomes than those in the middle and upper class. We saw this play out very clearly in the early days of the COVID-19 epidemic.

And on a global scale, wealthy industrialized nations have the resources to develop and produce pharmaceuticals that poorer countries cannot. The ethical approach to this disparity is to ramp up equitable distribution efforts and protect against transmission of diseases locally and internationally.  

The world needs more public health professionals

These three particular public health issues are ones that I am particularly passionate about, and I know that I am not alone. If you feel as strongly as I do about finding ways to enact lasting change, perhaps you are compelled to answer the call for more trained public health professionals.

If you’re curious about learning more, look no further than the Master of Public Health (MPH) program at Creighton University. As an MPH student, you will have access to expert faculty, a comprehensive curriculum, hands-on projects and research opportunities that prepare you with the skills you need to make a difference.

Learn more about the program by reading our article “What to Expect from a Public Health Degree.”

Maureen Tierney, MD, MS is the Associate Dean and Chair of Clinical Research and Public Health and a professor at Creighton University.