Intersecting Society and Health – Discussing Innovation in Public Health with Dr. Megan Ranney

Introduction

Public health has been a significant concern within the healthcare sector, specifically brought into focus after the recent pandemic. Creating efficient systems to enable public health has been a principle that dates to the founding of the American Republic. There are several examples of successful drives toward public health, such as ‘Habitat for Humanity’ and ‘Youth Engaged in Service’. Medicine and politics have always been closely linked and the healthcare sector is consistently tied closely with society and cultural norms. Each one is affected by changes in the other. This blog will explore how societal evolution drives innovation in the public health space.  

How HIV Affected Public Health: Cote d’Ivoire in West Africa 

In the late 90s, Cote d’Ivoire was suffering from an HIV AIDS epidemic. This area of West Africa needed immediate attention on prevention and care for the disease. However, the issue was more deep-rooted than just providing care and treatment for infected patients. It needed a close examination of the society and culture of the area. Cote d’Ivoire had a major highway which was the commercial artery for most of West Africa. Truckers would drive up and down the highway and spread HIV at the truck stops along the way. The first order of prevention was tied closely to the empowerment and education of women. At that point, there was no access to antiretrovirals in West Africa. Therefore, empowering women was the best way to address the mentioned public health issue.  

How COVID Affected Public Health: U.S. Emergency Room

The emergency room is the gateway to public health. The safety nets of the United States, many public health problems are seen first and most acutely in the emergency department.  

Among the first few cases of COVID, a child who was infected on a school trip to Italy, was intubated in the intensive care unit. Providing care to the child presented caregivers with a critical learning experience.  

It was a real-time reminder of all the areas that need improvement in the public health system. From limited access to COVID testing, wherein requests had to be formally faxed with long wait times, there was also a stark shortage of PPE suits. The primary caregivers, that is the doctors and nurses, were provided with PPE suits. However, the housekeeping staff did not have access to PPE suits to protect themselves from getting infected and thereafter infecting others. This brought about a realization of the way the disease would spread and how social structures and cultural norms would affect public health.  

Emergency medicine served as the tip of the spear for COVID response but also as an ideal for all the other problems across society. It provided a preview of the issues with the unhoused population that was infected and the stark reality that these patients had no refuge. 

How Firearm Injury Affects Public Health in the U.S. 

Firearm injury prevention is no different from any other type of public health intervention and prevention. One of the greatest failures of the U.S. public health system is the inability of applying efficient systems towards gun control and firearm injury. Public health, affected by firearm injury, needs a harm reduction philosophy, which has been used for every other major public health problem.  

The failure to use policy appropriately, create connections and community, and change norms toward safe firearm ownership lies at the crux of the problem. Since youth are at high risk of gun homicide, it would be prudent to develop violence intervention programs for youth. Similarly, programs to increase safe storage among rural gun owners who are at higher risk of gun suicide, which is almost two-thirds of gun deaths nationwide. Finally, putting in policies that require gun owners to be medically evaluated, prior to approval, can increase safety.   

The Four Critical Steps of a Public Health Model 

The public health model involves four steps: 

• Measuring the problem: This is an identification of the statistics, and an analysis of how far and wide public health has been affected 
• Identifying the risk and protective factors: An analysis of the risk factors and an identification of protection measures 
• Creating interventions – This is the measures undertaken to create interventions that decrease risks or improve protection 
• Scaling success strategies – Once the interventions are in place, the final step is about scaling up the measures that seem to be the most effective  

These four steps can be conducted across individuals, families, communities, or society. When applied efficiently, it has the potential to offer substantial results.   

Conclusion 

Not just for violence prevention, but for every part of public health, data is a critical component. Going back to COVID, there was a complete lack of data and demographics. 

Data sharing needs to be prioritized across healthcare entities, state agencies, and other related agencies. The CDC has been pushing for its data modernization initiative for quite a while. Innovation and data analysis is the lifeblood of public health. Explore more interesting topics and listen to insightful podcasts related to healthcare only on CareTalk.