Public Health Problems

The public health problems related to drug and alcohol abuse, smoking, obesity
untreated hypertension and diabetes; depression and suicide are well known. Poor
physical fitness has been recognized since the Presidency of John F. Kennedy.

These problems have been well documented in books and in the media.

  • Drug and Alcohol abuse
  • Smoking
  • Obesity
  • Sedentary Lifestyle
  • Hypertension
  • Diabetes
  • Anxiety, Stress and Depression
  • Suicide
  • Homelessness
  • Poverty              

Neuwirth in his book Reframing Healthcare quotes an article in the New England journal of medicine by Dr. Steven Schroeder that shows that 40% of illness is a result of behavior; 15% due to social causes; 30% genetic causes; 5% from environmental factors and 10% to lack of healthcare. This implies that improving access to healthcare will have little effect on public health. More focus on behavioral changes and social change will have over 5 times the impact on the nation’s health. Thus we need need to deal with the social and behavioral ills of our society in order to improve the public health. We know than man is a social animal and that without social contacts and social networks anxiety, stress and depression result. Drug and alcohol addiction, homelessness and suicide frequently result. With extended families drifting further apart and decline of religion in American life, social contacts and social networks are declining. This is in spite of social media keeping us more connected. Studies show that religious people in America live several years longer, have lower suicide rates and are generally healthier than their secular counterparts. This is in spite of social media keep us more connected. Poverty also contributes to mental illness through financial stress. When someone becomes physically or mentally ill, a support system is necessary for both physical and emotional support. Historically, this has been the family as well as support from religious institutions. Bullying and shaming on social media have contributed to depression and suicide especially in the young.


HealthCare Delivery Problems ( or as Sando Galea puts it Sickcare Delivery Problems) 

High and rising costs – 7% of GDP in 1977 to 18% of GDP today with little improvement in health

Overutilization of healthcare services e.g. excessive placement of cardiac stents

Shortages of healthcare services e.g.difficulty in getting appointments especially for the poor

Poor communication of healthcare data e.g. Electronic medical records are not compatible

Resistance to new innovations in healthcare delivery

Physician Burnout

Waste, Fraud and Abuse 

Medical Bankruptcy