Envisioning a Healthier Future

Together, we must transform the way our country approaches health. We need a greater focus on prevention and wellness so we don’t need treatment as often. We need to better address the broader issues that affect health—from poverty to poor housing, education, transportation and the environment. It’s not enough to individually make choices that will improve our own health. We need to make sure everyone in all communities has the chance to make those same healthy choices.

We applaud the goals of National Public Health Week quoted above (https://www.apha.org/topics-and-issues/healthiest-nation). At the same time, we contemplate the unrealized dream of Martin Luther King Jr. during this winter of racial strife, not only in the United States, but throughout the world, from Ferguson to Paris. In the words of Coretta Scott King, “The King Holiday celebrates Dr. King’s global vision of the world house, a world whose people and nations had triumphed over poverty, racism, war and violence. The holiday celebrates his vision of ecumenical solidarity, his insistence that all faiths had something meaningful to contribute to building the beloved community” (http://www.thekingcenter.org/meaning-king-holiday).

As part of envisioning a healthier future, we must confront the hard truths about the egregious inequalities that drive the terror and desperation experienced by far too many of us. And yet, we must stay the course in disseminating and implementing the evidence-based strategies to prevent more commonplace injury and disease that are by far and away the greatest threats to individual and collective well-being.

According to the Centers for Disease Control and Prevention, adult seat belt use is the most effective way to save lives and reduce injuries in crashes. Yet millions of adults do not wear their seat belts on every trip, and road traffic crashes are the leading cause of death for individuals between the ages of 15 and 29 years worldwide. And while immunization against the human papillomavirus (HPV) can prevent cancers in both women and men, the uptake of the HPV vaccine lags far behind other adolescent vaccines, especially for boys.

Despite these challenges, the realization of a healthier future is likely to become manifest for certain population groups. First, the Patient Protection and Affordable Care Act provided 10 million people with health insurance coverage over the past year alone while also reducing inequality. Data analyzed from Enroll America and Civis Analytics demonstrated that the law was especially successful in covering young people between the ages of 18 and 34 years, African Americans and Latinos, and those who live in rural areas. Notably, the US regions with the largest increases in health insurance rates were rural Arkansas and Nevada; southern Texas; large swaths of New Mexico, Kentucky and West Virginia; and much of inland California and Oregon.

Second, the US Supreme Court justices agreed to decide a major civil rights question this spring, namely, whether same-sex couples have a right to marry everywhere in the United States under the Constitution. Findings published in AJPH suggest that psychological distress is lower among gay, lesbian, and bisexual people who are legally married as compared with gay, lesbian, and bisexual people who are not in unions respected by their states.

As committed public health researchers and practitioners, we envision a healthier future where communities strive together to improve the economic conditions under which people are born, grow, live, work, and age. We envision a healthier future with a focus on eradicating the determinants rather than merely alleviating the symptoms of disease, on effectively preventing rather than belatedly treating injuries, on educating rather than imprisoning impoverished youths.

We envision a healthier world that supports everyone across the life course by recognizing our interdependence on one another across generations, national boundaries, and faiths, and where access to primary health care is the norm, not the exception. We envision a healthier planet where science and technology are used to safeguard rather than destroy the environment. We envision a healthier future where Dr. King’s great dream of vibrant, multiracial societies are united in peace, justice and reconciliation.