Invest in public health now for healthier future, experts urge

The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The special issue includes 18 timely editorials, commentaries, and research on the challenges of public health financing -- highlighting the need to increase investment in public health. These articles are open access on the journal's website (http://journals.lww.com/jphmp/pages/default.aspx). "If we fail to strengthen our public health system now, we can look forward to falling further behind other developed nations and it will become more and more difficult to restore our health and competitiveness," according to Steven M. Teutsch, MD, MPH, of the Los Angeles County Department of Public Health and colleagues.

Investing in Public Health Is Imperative to National Health and the Economy

The lack of attention to public health and prevention has serious consequences not only for the nation's health but also the economy. A healthy workforce is essential to "sustain economic growth and continued gains in labor force participation and longevity," Teutsch and colleagues believe. Coverage for medical treatment is essential -- but the dollars invested in clinical care far exceed its contributions to the nation's health. Medical care accounts for only 10 to 20 percent of the factors that shape health, but accounts for about 97 percent of all health spending, according to Teutsch and coauthors.

While total annual U.S. health spending is approximately $2.5 trillion, or about $8,100 per person, only $250 is related to public health. And while the U.S. spends twice as much per year as any other industrialized country, Andrew S. Rein, MS, and Lydia L. Ogden, PhD, MPP, of the Centers for Disease Control and Prevention state that that its health system ranks 37th in the world -- just behind Costa Rica.

They outline a multi-pronged -pronged solution to the chronic problem of public health underfunding in the United States, starting with efforts to increase productivity and efficiency. Suggestions include defining an essential minimum package of public health services and developing new approaches to address problems that contribute to poor health or stand in the way of health improvement, including high-cost but preventable conditions as obesity, diabetes, and smoking.

According to Patrick Bernet, guest editor of this special edition, "The U.S. needs to get the most out of the public health investment by focusing on programs that pay for themselves by decreasing illness and death, and through new public health partnerships at the state, local, and community levels."

Call to Increase Resources for Public Health

In addition, Teutsch and colleagues believe it's essential to establish "sufficient, stable, and sustainable" revenue to support public health efforts. To meet this end, they endorse the Institute of Medicine's recent proposal to institute a national medical care services tax. "A tax on medical services could slightly increase costs," they write, "but it has the potential to begin turning the tide of patients pushed into the system by preventable conditions."

Teutsch and coauthors add, "Although 2012 may not be a propitious time to increase spending, the United States cannot afford to delay as the costs of chronic conditions and an aging population skyrocket. The status quo is not working and we cannot afford to maintain it."

The special issue of Journal of Public Health Management and Practice also includes expert editorials on the importance of ensuring funding for public health research and measuring progress in public health finance. Rein and Ogden conclude, "This issue keeps us focused on critical issues of finance, so that public health can offer all it can for our future."