The Future of Public Health

by U.S. National Academy of Sciences, Committee for the Study of the Future of Public Health, Division of Health Care Services

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health . This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government?federal, state, and local?at which these functions would best be handled.

240 pages, Paperback

First published January 1, 1988

Reviews

[Ying · Rating 5 out of 5]

The reason why I picked this book is that it is a perfect combination of the past and the future. This book was written nearly 30 years ago by a group of experts of public health in the US. That is to say, all situations and the environment described, and concerns and questions raised in the book were concerning the public health system in the late 1980s. Our readers can use this book as a historical book to gain an understanding of the public health system in the US 30 years ago. Moreover, the reader can compare the past situations with the current to see what has changed and what remains the same since then. Meanwhile, the authors also made recommendations for future developments based on their assessments and understanding of the public health system back then. This book has provided us readers a great chance to consider whether these recommendations are appropriate or not and explore the challenges and opportunities for the contemporary and future public health agencies and institutions.

Harry Truman once said, “The only thing new in the world is the history you do not know.” This is the first lesson I learned from the book, the history of the public health system in the US. From the history of public health, I gained an understanding that the development of contemporary public health system reflects the development of knowledge about the disease pathogen and pathology and public awareness of responsibility. Before the nineteenth century, people perceived disease as results of poor moral and spiritual condition and the method to deal with the disease was to isolate and quarantine patients and travellers. However, as knowledge and technology developed, people started to realize that it is the pathogen that caused the disease not the moral and spiritual conditions. This understanding of the cause and meaning of disease also encouraged people to take more responsibilities in the control of disease.

The second lesson I learned from the book is that the knowledge and sciences which public health professionals relied on to make informed and evidence-based decisions can be a restriction when encountered with politics. In the political process, decisions are made by the influence of a multitude of factors beyond academic knowledge, such as crises, hot issues, interest groups, public attention and support. As a result, compared with the impact of politics, the scientific knowledge public health professionals used to make comprehensive and objective decisions has a relatively limited influence on the institutional decision-making process. This understanding also reminds me of the 3-I framework which I learned in the policy class that interests, ideas and institutions compound influence policy developments and choices.
One of the many strengths of this book is that it provides readers with strategical recommendations for improvement of the future public health system. More importantly, these recommendations are based on evidence that collected from a detailed study of the public health system in the United States regarding demographic and epidemiologic statistics, agency budgets, organization charts, program plans, statutes, and regulations. This book made judgments about the current state of the public health system through a holistic and explicit approach which would help readers to have a critical appraisal of judgements of the public health system and recommendations of future developments.

However, this book is not without limitations. One major weakness of the book is that it mainly fused on the American’s public health system rather than the state of public health worldwide. The United States’ health care system has been ranked 37th on the World Health Organization 2000 Health Report which indicates that there are lessons and experience of global healthcare systems that public health professionals in the US could learn and adapt to strengthen their public health system.
One possible reason why we want to know the future is that we want to make the right decision and set ourselves on the right pathway to success. However, the most crucial point is that without having a clear understanding of the past and current situation of ourselves, it is difficult to know what the right choice is and where is the way that can lead us to the direction we want to go. As for future public health practitioners, you will find the answer to how to head in the right “next-step” direction in this book.

[Aleah Briarly · Rating 5 out of 5]

Amazing or insane that for so much of this report it sounds like they are talking about today and I had to remind myself that this was almost 40 years ago. I like that ultimately this can be chalked up to: give us universal healthcare and then build up from there. I definitely need to learn more about the AIDS epidemic as that was the public health issue of this time, I often forget just how impactful that was to our history. I wonder what the future of public health will look like next, because this shit will not fly for another 40 years...