As we quickly approach 1 million deaths in just over two years to the COVID-19 pandemic, it is hard for many of us in the public health world to normalize it. When did a million deaths become acceptable to Americans?
Conversely, if a newspaper was published only once every 100 years, what would the banner headline be for the past century? Author Steven Johnson describes this classic thought experiment in a Ted Talk, arguing the headline during this timeframe is the doubling of humanity’s life expectancy.
Incredibly, global life expectancy increased during the past century from the mid-30s to over 70 years of life. Doubling life expectancy represents phenomenal progress.
While medical advancements played an important role, the lion’s share of credit for this achievement goes to innovations and practices to protect the public’s health, ranging from improvements in clean water and sanitation to lives saved from seatbelts, vaccines and addressing infant mortality.
It’s important to note life expectancy in the United States hit several speed bumps in the past 7 years, according to the Centers for Disease Control and Prevention (CDC). That includes a 2020 life expectancy decline at birth from 78.8 years in 2019 to 77.0 years in 2020— the largest decline since World War II.
The reasons behind recent life expectancy declines are complex but familiar, such as increases in deaths due to opioids, suicides and alcohol-related causes. But there are other contributors. For instance, there’s been an increase in cardiovascular-related deaths after a 50-year decline and, of course, the COVID-19 pandemic.
There are looming, ominous health threats as well. Just last year, the World Health Organization declared climate change as the greatest single threat to humanity, giving us a glimpse into what the headline might read in the next century. Like most threats, climate change will have the greatest impact on those economically and socially marginalized.
The way to counter the effects of threats from cardiovascular disease to climate change is turning to the successful approaches of the past to protect the public’s health — and to give the public health protection community the supports needed to get the job done.
Unfortunately, prior to the COVID-19 pandemic our government at all levels didn’t do that. In fact, the Trust for America’s Health indicates the United States spent $3.8 trillion on health in 2019, with just 2.6 percent directed toward the public’s health and prevention — the smallest share since 2000. If we’re honest, our public health systems for all their strengths are weak at the seams due to the legacy of longstanding disinvestment.
Since the start of the COVID-19 pandemic, those protecting the public’s health have been in the headlines, and the cameras have focused intently on CDC and health departments with health officials receiving praise, but also criticism and personal threats. Federal funding, appropriately, for protecting the public’s health increased during the pandemic and attention is now focused on modernizing our system for the future.
There’s also much each of us can do to create a healthier future for us all. Here are five ways:
- Follow the guidance of public health protection officials — they are there to protect you and those you love.
- Encourage your government officials at all levels to strengthen their public health structures by providing consistent, predictable funding. Also, encourage elected officials to not pass laws limiting the ability of public health to protect us all.
- As an employee or a business owner, look for opportunities to engage with your health department to protect your employees, your livelihood and your community.
- Share what you know to be factual when you hear people — your friends, co-workers or family — sharing inaccurate information contrary to the evolving science aimed at saving lives.
- To ensure we have the workforce we need for the future, encourage the next generation to explore a lifesaving role in the noble profession of protecting the public’s health.
Today, and for tomorrow, we need to work together across the public and private sectors to rebuild a strong, trusted system to protect the public’s health, one able to rise to the enormous challenges to our health and economic well-being. Our lives — and our longevity— depend on it.
Judith Monroe, M.D., is president and CEO of the CDC Foundation, based in Atlanta. She has been a deputy director of the U.S. Centers for Disease Control and Prevention (CDC) and director of CDC’s Office of State, Tribal, Local and Territorial Support. The CDC Foundation mobilizes philanthropic and private-sector resources to support CDC’s critical health protection work, managing hundreds of programs in the United States and in more than 140 countries.