If you look at it, past centuryAs we go through a back and forth between Republican and Democratic presidents, we see a continued and strong commitment to science-based public health practices.
This effort has had incredible results AchievementsThis includes controlling infectious diseases, sharply reducing deaths from heart disease and stroke, safer and healthier foods, healthier mothers and babies, family planning, fluoridation of drinking water, and the use of fluoridation as a health hazard. Includes tobacco awareness and the elimination of more than one. 20 diseases that can be prevented with vaccines.
However, there is a possibility that President Trump will be re-elected and that Robert F. Kennedy Jr. will take office. play an important role in public healthmany medicine and public health have big concern Changes to the decades-old habits and programs that protect us are looming.
Advocates of fringe public health and scientific causes, including the anti-vaccination movement and the closely related anti-fluoridation movement, have never held significant seats in a presidential administration. culture warIt has invaded American politics and degraded expert opinion.
among them Anxiety that many people feelit is important to recognize that even if effective public health recommendations are withdrawn nationwide, such changes will not have an immediate impact. The momentum of effective public health measures that have been widely applied for years is long-lasting.
However, ideological changes in national public health mean that the direction of public health will shift to the state and local levels, reorienting public health approaches to protect us and adapting to the new era. you'll need to.
The federal government provides funding and US Department of Health and Human Servicesthe Centers for Disease Control and Prevention and the National Institutes of Health play a role in the development and implementation of public health policy.
However, public health authorities are provincial and vested by the state. 10th Amendmentprovides that “the powers not delegated to the United States by the Constitution, or prohibited by the Constitution to the States, are reserved to the States or to the people, respectively.”
Unfortunately, amidst the recent coronavirus disease (COVID-19) pandemic, Disinfected or forgottenwe saw this principle in action. Although there was guidance from the other party, White House Coronavirus Task ForceNIH and CDC, and hundreds of billions of federal dollars supporting state public health; individual condition We have developed a unique approach to combating the novel coronavirus.
States, rather than the federal government, regulated whether schools could open or close. Each state has also developed its own coronavirus vaccination policy.
When considering local public health responses and recommendations, and how states can pivot, the following should be considered: Structure of the state public health system is different. Some states have a centralized system in which the state health department supports and directs statewide policy. Other states, counties, or other jurisdictions determine local public health policies and regulations, not the state.
of Scope of activities between countries Local health departments also vary. Some health departments manage school health programs, while others do not. Some departments recommend childhood vaccination, while others prohibit it.
This lack of uniformity means that it is more difficult to develop and implement new local policies in some states and jurisdictions than in others. Additionally, state and local public health policies will be affected by: political ideologyas reflected by Cancellation of childhood vaccinations at schoolrequirements.
We are now entering an unprecedented time of public health crisis at the federal level. Influenced by non-mainstream sources and has no scientific basisperspective. Some of these perspectives will be from politicians Supported by anti-vaccination groupsand some come from doctors who practice medicine outside the mainstream. political purpose.
Given the new peripheral influences on public health policy, it would not be surprising for the federal government to withdraw financial support for established public health programs. we may also see federal guidelinesContrary to established scientific, medical, or public health practices.
This possibility will lead state and local health officials to rely on other channels for legitimate information. peer public health network and public health organization You will need to provide accurate information.
A major public health mission is to respond to infectious diseases, both established and new. A major challenge in responding to the COVID-19 pandemic has been the biology of a new virus that, unlike many other respiratory viruses, is contagious long before an infected person becomes ill. .
of Response to virusesIt has exposed our lack of preparedness on many levels, but it has also shown how we can respond through the development of new treatments and vaccines. Thus, after the recent 100-year pandemic, there has been increased interest in the resurgence of pandemics. pandemic planand new offices mandated by Congress. Pandemic preparedness and policy responseIt was established in the White House by the Biden administration.
But similar to how the previously established White House pandemic planning team operated; removed by President TrumpIn 2018, this program may be phased out again. As well as information dissemination, public health agencies and academic institutionWe need to fill in this blank.
When he was running for President Trump, he threatened to take away fundsFrom schools where vaccinations are mandatory (nearly all public schools in the United States)
Contrary to the opinion of almost all doctors, medical institutionRobert F. Kennedy Jr. has expertise in infectious disease and vaccine science. Objected to the need for childhood vaccinations.
Dr. Joseph Ladapo, currently Florida's Surgeon General and being considered for a leadership position at HHS, alsosupport these views— the only state health official to do so. Therefore, support for the federal government childhood vaccinationsProgram is threatened.
According to the report, it is important that federal childhood vaccine programs consider:thwartedMore than 500 million people sick in the US, more than 32 million hospitalizations, $540 billion in medical costs, $2.7 trillion in social costs, and 1.1 million deaths
Changes in federal ideology related to childhood immunization guidance and changes in federal support for immunization programs will shift the need to support such programs to states, local health plans, and health care providers. Dew. Rather than having the federal government pay for the vaccine; Children targeted for the programBecause this includes about 50% of all children in the United States, vaccine costs will be passed on to state child insurance programs, creating additional costs for each state.
as Childhood vaccination rateAs the tide goes out, local outbreaks of measles and other diseases are inevitable in areas where vaccination is inadequate. The Ministry of Health now needs to strengthen its outbreak response team.
States that fail to deliver on this axis of protecting and promoting childhood vaccinations will face severe disease impacts on children and families, school closures, and community disruption. Fortunately, there are several medical providers, including: American Academy of Pediatricshealth departments, medical professionals, and the general public to seek useful information.
Approximately 145 million people currently drink alcohol in the United States. fluoride waterhas been proven to be beneficial in reducing tooth decay. However, concerns have been raised about the negative effects associated with it. excessive fluoridation. Considering recent public statements by Kennedy Jr., one might conclude that: Federal Recommendations for Water Fluoridation.
If this sentiment takes hold, it will create options for states, the medical community, and the public. Pediatricians can prescribe fluoride tabletsis a daily habit for children with well water rather than public tap water. Pediatric healthcare workers can also apply Fluorine varnishReduces the risk of tooth decay.
Without such measures, we will see an increase in tooth decay, increasing the economic burden on nations and families. In the face of increasing cavities rates in pediatric dentistry, states will need to address how to pay for and improve their scarce pediatric dental workforces. many parts of the united states.
rear Initial unified approachLeading up to the pandemic, there was a dramatic disparity between red states and blue states when it came to COVID-19 response. The serious impact of this disparity cannot be denied. Mortality rates in red statesOutperformed blue states. Other core public health activities, particularly those related to children, were similar across regions.
Sadly, we have to ask whether we will see a disparity between red states and blue states when it comes to the health of our children. Will we post red and blue state maps for outbreaks of measles and other vaccine-preventable diseases, as we do for COVID-19?
We can avoid this travesty by reflecting on the Tenth Amendment and understanding that states not only have the power, but also a duty to protect children. No matter where we live, we should ask what our state is doing to protect our families from malicious and false claims against basic public health protections.
Scott A. Rivkees, MD, is a professor of practice at the Brown School of Public Health. He is a pediatrician and former state surgeon general and Florida health secretary.
