Environmental News for a Healthier Planet and Life

Help Support EcoWatch

How Healthy Is America’s Public Health Infrastructure?


By Jeff Turrentine

From day to day, our public health infrastructure — the people and systems we've put in place to keep populations, as opposed to individuals, healthy — largely goes unnoticed. That's because when it's working well, its success takes the form of utter normalcy.

Never mind that a vast number of people from a wide variety of fields — science, medicine, law, engineering, education, advocacy, and public policy — must work tirelessly (and often thanklessly) to grace our everyday lives with that blissful sense of normalcy. If you pour and drink a glass of tap water, head outside to take in some fresh air, then come home and prepare dinner, you can thank a public health worker for making every step of that routine healthier.

But there are times when we suddenly become very aware of just how well our public health systems are, or aren't, working. Today, in the midst of a pandemic, we're living through one of these moments. Our public health infrastructure is being tested. And as the COVID-19 crisis continues to intensify, it has become glaringly apparent in most parts of the country that this infrastructure is underfunded and overstressed.

A Washington Post article from two weeks ago, written before "social distancing" became part of our lingua franca, explored some of the reasons why. Because public health infrastructure targets the entire populace, the article observed, its mission "has been consistently overlooked in a country that puts a premium — and spends more money per capita than any other — on treating individual sick people. Its victories are soon taken for granted." The author cites figures from a 2019 paper published in the American Journal of Public Health showing that our country's investment in public health is currently $19 per person annually. According to experts in the field, that's $13 less than what it should be.

Meanwhile, we Americans spend, on average, almost $11,000 per person annually on treatments for the various diseases and conditions that routinely befall us. When people complain about the oppressive costs of health care, it's this back-end spending that they're talking about. But guess what? The country could lower these costs significantly by making smarter investments at the front end — i.e., spending more to protect the health of the public as a whole.

"There's a real need for people to see how the public health agenda directly protects everyone's well-being by addressing the root causes of disease and early death," said Vijay Limaye, an environmental health scientist at NRDC's Science Center. Investments in public health also help to make individuals more resilient. As an example, Limaye noted that "our country's progress on cleaning up air pollution has sharply reduced the burden of disease, including heart and lung conditions that put certain people at higher risk of severe illness from the coronavirus."

And right now, as local and state officials struggle to persuade some in their communities to heed the warnings against gathering in groups, another aspect of our public health infrastructure has risen in importance: communication. Few Americans knew what "flatten the curve" or "social distancing" meant three weeks ago. But thanks to creative, relentless messaging and the power of the internet and social media, Limaye said, "we're able to get the word out about the urgent need to slow down the rate of infections and better equip our health-care professionals on the front lines."

Though President Trump and some state officials have expressed impatience with social distancing measures that have closed businesses and caused unemployment to soar, there's little question that these are effective strategies for slowing transmission rates. Kinsa, a health technology company that makes digital thermometers and tabulates data on its customers' readings and reported symptoms, said the number of people exhibiting flulike symptoms such as fever began dropping precipitously and immediately after social distancing rules went into effect in places like New York City and Northern California. The same data set also reveals that incidences of flulike illness increased in cities and regions that were late in taking action, such as South Florida.

In the gap between those two trajectories, we see the difference between a robust, nimble public health response and an ill-prepared or hesitant one. And when you compare nations, the importance of early and accurate data collection — combined with powerful, consistent messaging — becomes even more apparent. South Korea was hit hard by the coronavirus in late February and early March, at one point reporting almost 1,000 new cases in a single 24-hour period. But thanks to a national strategy that has emphasized testing, social distancing, self-isolation, and GPS- and cell-phone-aided tracking and communication, this country of almost 52 million people reported only 64 new cases on Monday.

That's how public health infrastructure is supposed to work in the midst of a pandemic. "Other countries like South Korea are miles ahead of the United States on early and aggressive disease tracking and targeted health-risk communication, using things like location-based phone applications," Limaye said. "It's time that we harness 21st-century tools to better protect our citizens. In the year 2020, the public demands timely, transparent, and trusted information. There's simply no excuse for delays or deficiencies in reporting testing and health data."

But that, of course, would require a much greater investment than what America is currently making. In the 2019 paper on public health spending mentioned above, the authors recommended creating a $4.5 billion public health infrastructure fund that could generate new, permanent resources for state and local governments across the country. That probably sounded like a lot of money to any legislators who bothered to read the report when it came out. But now lawmakers are hashing out the final details of a $2 trillion relief package designed to save an economy that's been ravaged by the rapid spread of a dangerous communicable disease.

Let's hope it helps. And let's hope that all of us come to understand the importance of social distancing, hand washing, and other strategies for combating the spread of the coronavirus — strategies brought to you by the highly informed, highly dedicated public health professionals who are always looking out for us, 24/7, whether we're struggling through a pandemic or just going about our day.

Reposted with permission from onEarth.

EcoWatch Daily Newsletter

By Samantha Hepburn

In the expansion of its iron ore mine in Western Pilbara, Rio Tinto blasted the Juukan Gorge 1 and 2 — Aboriginal rock shelters dating back 46,000 years. These sites had deep historical and cultural significance.

Read More Show Less
Meadow Lake wind farm in Indiana. Anthony / CC BY-ND 2.0

By Tara Lohan

The first official tallies are in: Coronavirus-related shutdowns helped slash daily global emissions of carbon dioxide by 14 percent in April. But the drop won't last, and experts estimate that annual emissions of the greenhouse gas are likely to fall only about 7 percent this year.

Read More Show Less
Andrey Nikitin / iStock / Getty Images Plus

By Adrienne Santos-Longhurst

Plants are awesome. They brighten up your space and give you a living thing you can talk to when there are no humans in sight.

Turns out, having enough of the right plants can also add moisture (aka humidify) indoor air, which can have a ton of health benefits.

Read More Show Less
A bald eagle chick inside a nest in Rutland, Massachusetts. Massachusetts Division of Fisheries and Wildlife
A bald eagle nest with eggs has been discovered in Cape Cod for the first time in 115 years, according to the Massachusetts Division of Fisheries and Wildlife (Mass Wildlife), as Newsweek reported.
Read More Show Less
The office of Rover.com sits empty with employees working from home due to the coronavirus pandemic on March 12 in Seattle, Washington. John Moore / Getty Images

The office may never look the same again. And the investment it will take to protect employees may force many companies to go completely remote. That's after the Centers for Disease Control and Prevention (CDC) issued new recommendations for how workers can return to the office safely.

Read More Show Less
Frederic Edwin Church's The Icebergs reveal their danger as a crush vessel is in the foreground of an iceberg strewn sea, 1860. Buyenlarge / Getty Images

Scientists and art historians are studying art for signs of climate change and to better understand the ways Western culture's relationship to nature has been altered by it, according to the BBC.

Read More Show Less


Esben Østergaard, co-founder of Lifeline Robotics and Universal Robots, takes a swab in the World's First Automatic Swab Robot, developed with Thiusius Rajeeth Savarimuthu, professor at the Maersk Mc-Kinney Moller Institute at The University of Southern Denmark. The University of Southern Denmark

By Richard Connor

The University of Southern Denmark on Wednesday announced that its researchers have developed the world's first fully automatic robot capable of carrying out throat swabs for COVID-19.

Read More Show Less