It's time to talk about the subject that has been the most taboo over the last three years.....
Let's talk about public health.
The Greatest Failure of Public Health
Over the course of the pandemic public health failed miserably to take a holistic approach to health. Public health has failed in its overarching mission to fulfill society’s interest in assuring conditions in which people can be healthy.
There was a hypnotic focus on this one infectious disease that did not affect everyone equally. As we observed early in 2020, those most at risk for severe disease and death from infection with SARS-CoV-2 were the elderly and those with underlying health conditions such as diabetes and obesity. However, all people were treated the same way as if they were all at the same risk of severe disease and dying when infected with SARS-CoV-2.
Source: https://www.statista.com/chart/20860/coronavirus-fatality-rate-by-age/
How is Health Defined by Public Health
The World Health Organization (WHO) has defined health as a dynamic state of complete physical, mental, spiritual and social well-being and not merely the absence of infectious disease.
Public health is what we do collectively as a society to assure the conditions in which a person can be healthy. While the goal of clinicians is to save lives one at a time, the overarching goal of public health is to save lives millions at a time. This is done by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases. During an urgent threat to public health, public health officials must serve in an advisory role to maximize public health benefit while minimizing disruptive social consequences.
Work of public health lies within three core functions: assessment, policy development and assurance. Public health is guided by ten essential public health services which serve as a framework to promote health of ALL people in ALL communities. This must be the prime consideration when making recommendations in order to balance collective actions for the common good with individual liberties.
10 Essential Services of Public Health:
Source: https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html
The Main Dimensions of Health
There are at least five dimensions of health, although some would add a few others as shown below. Our wellness as human beings is dependent on the integrity of every aspect of our being. As a matter of fact, any part that is neglected or falls into disrepair will impact our whole life.
Source: https://thehammockllc.com/designing-a-wellness-wheel-health-wellness-coaching/
Spiritual: participating in spiritual activities
Social: which includes relationships, intellectual conversations, and networking
Emotional: openly expressing thoughts, feelings, and being able to deal with them appropriately
Physical: proper nutrition, sleep, and movement
Environmental: safe and comfortable surroundings and resources available
Financial: getting basic needs met, and being comfortable living within their means
Goals and Aspirations: having desires, hopes, short and long term attainable aspirations and goals
All people do not have the same priorities when it comes to these dimensions of health. Individuals would rank the dimensions of health differently in order or priority based on what is most important to them. For instance, for some people having a job and being to provide for themselves would rank as most important while others find that spirituality is the most important aspect to their health.
Health Agencies Abandoned Health
In brief, governors across the U.S. issued emergency proclamations to stay at home, ban social gatherings and shut down business and services by recommendation of public health officials. Churches were asked to close and schools were shuttered with most children moving to online learning platforms.
Determination of which businesses to close was based on classifying them as either ‘essential’ or ‘non-essential’. This is the first time in history that businesses and individuals have been classified as ‘essential’ versus ‘non-essential’ in response to a disease outbreak.
All businesses are essential for the health of all people in the community. Any job which enables someone to provide for themselves and their family is essential.
An essential business was defined as one that provided products or services that people rely on every day or that may be necessary for some during this time period. Businesses considered ‘essential’ in one state weren't designated the same way in others. In general, nonessential businesses was defined as those that provide something beyond the basic necessities.
Depending on the business's operational functions, nonessential employees were either ordered to work from home or accept paid or unpaid leave. In many cases, nonessential employees were laid off because businesses were not making enough sales or because they were required to shut down.
Establishment closure and opening was an important feature of the early pandemic; more than 700,000 establishments closed in the second quarter of 2020 (left panel), accounting for nearly 3 million jobs (right panel) out of 20 million gross job losses occurring in that quarter (not shown).
This has had a devastating impact on the wellbeing and livelihoods of many people. As a result of public health officials’ decision to shut down businesses, unemployment rates have skyrocketed and food insecurity has risen dramatically in addition to the detrimental impact on mental health with increased levels of loneliness and anxiety.
There is no scientific foundation on which the determination of essential services was made. Closing schools, churches and shuttering businesses has decreased the overall health of the population by impacting several key areas of health and wellness. These key areas of health and wellness have been sacrificed unnecessarily under the guise of eliminating a threat to health.
Given the differential risk of SARS-CoV-2 infection, public health agencies should have talked about reducing risk to thereby reduce the possibility of severe disease via exercise and proper nutrition. Instead, people gained weight during the shutdowns. In fact according to a study looking at 15 million patients' weight changes, 39% of patients gained weight during the pandemic, with weight gain defined as above the normal fluctuation of 2.5 pounds. Approximately 27% gained less than 12.5 pounds and about 10% gained more than 12.5 pounds, with 2% gaining over 27.5 pounds.
The best public health response would have been to tell people to go outside at least half an hour a day, walk, go for a swim, or provide free exercise programs. The best businesses to have closed done would have been fast food restaurants and not gyms.
Can we now rely on the corrupt, captured organizations that destroyed public health to get us back to a state of health?
It is time for each of us to take control of our own health and the health of our communities.