Rift Valley University Department of Public

Health Abichu Campus

Academic Year 2022

Department of MPH

Assignment ፦ Contemporary issues & Emerging Public Health problems.

Section -B
Subject: Introduction of Public Health
Date of Submit: November 12, 2022
Submit To: Worku Dechasa(Ass't Professor, PhD fellow,)
List of Group 5 members
 Sofani Birhane
 Workineh Tolosa
 Mulualem Tilahun
 Henok Fikadu
 Sara Zimargachew
 Eyerusalem Alemu
 Nigist Kelemework

Addis Ababa Ethiopia

 Nov 2022
INTRODUCTION
Contemporary issues and emerging public health problems
Since early 2020, our world has been grappling with a devastating global
pandemic. The spread of COVID-19 has caused an estimated 2.5 million
deaths around the globe. Every day, there are health epidemics affecting
our populations. While the novel coronavirus continues to take center
stage, issues like climate change, opioid abuse, and childhood obesity
continue to impact our society.

These public health issues have not taken a break during the pandemic.
Some have escalated. However, there is good news. Thanks to the
advancements of modern medicine and rapid technology, progress is being
made. Treatment plans are being implemented, and lives are being saved.
Public health professionals are the ones to thank for this improvement.

Whether you have always been interested in making a difference, or the

public health problems of our day have inspired you, you may be
considering a future in this field of work. According to the Centers for
Disease Control and Prevention (CDC) and the World Health
Organization (WHO), the following are among the top public health
problems of modern day:
  COVID-19

The ongoing pandemic remains front and center for public health officials.
The deadly virus has put the entire world in a state of emergency. The CDC
continues to provide guidance on precautions like mask-wearing, social
distancing, and other preventative practices. Healthcare professionals have
come out of retirement and traveled to areas with high case counts, to help
fight this disease. Thanks to the diligent work of scientists and public health
researchers, multiple vaccines have been developed and are helping to
curb the infection rate. President Biden has also been working to increase
the number of vaccines available, and expects all Americans to have
access by August 2021.

 Mental Health Conditions

One of the many unfortunate side effects of the pandemic has been a
decline in our mental health. Quarantines, remote work, and distance
learning have impacted people of all ages. With tight restrictions on social
gatherings, many people are experiencing severe feelings of isolation and
distress. In fact, the rates of depression and anxiety are on the rise, which
is largely due to social isolation and loneliness. According to Forbes, 70
percent of teens are currently struggling with mental health issues. 60
percent of youth and adults are not getting the mental health treatment they
need. As more people need mental health services, we can expect to see a
growing demand for public health and mental health workers.
  Alcohol & Substance Abuse

Much like mental health, substance abuse is another growing concern. This
was among the top public health problems before the pandemic started, but
it has only been amplified in the days of self-isolation. Studies report that,
since the enactment of stay-at-home orders, suspected overdoses have
increased 18 percent. According to the CDC, 40 percent of U.S. adults
report struggling with mental health or substance abuse.

 Food Safety

Each year, 1 in 6 Americans get sick from eating contaminated food, and
3,000 die from this cause. Due to this constant, potential public health
threat, the CDC tracks food borne illnesses and works with the FDA to
ensure proper food safety practices. Public health professionals that
specialize in food safety and inspection are also in high demand.

 Food Security

Globally, climate change is expected to threaten food production and

certain aspects of food quality, as well as food prices and distribution
systems. Many crop yields are predicted to decline because of the
combined effects of changes in rainfall, severe weather events, and
increasing competition from weeds and pests on crop plants. Livestock
and fish production are also projected to decline. Prices are expected to
rise in response to declining food production and associated trends such
as increasingly expensive petroleum (used for agricultural inputs such
as pesticides and fertilizers).While the U.S. will be less affected than
some countries, the nation will not be immune. Health can be affected in
several ways. First, Americans with particular dietary patterns, such as
Alaska Natives, will confront shortages of key foods. Second, food
insecurity increases with rising food prices. In such situations, people
cope by turning to nutrient-poor but calorie-rich foods and/or they endure
hunger, with consequences ranging from micronutrient malnutrition to
obesity. Third, the nutritional value of some foods is projected to decline.
Elevated atmospheric CO2 is associated with decreased plant nitrogen
concentration, and therefore decreased protein, in many crops, such as
barley, sorghum, and soy. The nutrient content of crops is also projected
to decline if soil nitrogen levels are suboptimal, with reduced levels of
nutrients such as calcium, iron, zinc, vitamins, and sugars. This effect
can be alleviated if sufficient nitrogen is supplied. Fourth, farmers are
expected to need to use more herbicides and pesticides because of
increased growth of pests and weeds, as well as decreased
effectiveness and duration of some chemicals. Farmers, farmworkers,
and consumers will be increasingly exposed to these substances and
their residues, which can be toxic. These impacts of climate change on
the nutritional value of food exist within a larger context. Other factors,
such as agricultural practices, food distribution systems, and consumer
food choices, also play key roles. Adaptation activities can reduce the
health-related impacts of some of the anticipated food security
challenges.
  Healthcare-Associated Infections

We know that hospitals help patients recover and heal from illnesses and
injuries, but we don’t always think about the healthcare-associated
infections (HAIs) that can come from treatment. These can be caused by
the devices used in medical procedures, like catheters or ventilators. They
can also happen at surgery sites, known as surgical site infections.While
significant progress has been made in preventing some of these HAIs,
there is much more work to be done. According to the CDC, on any given
day, about 1 in 31 patients has at least one HAI.

 Heart Disease and Stroke

19 pandemic According to the American Heart Association’s latest findings,

heart disease remains the leading cause of death worldwide. Experts
predict that the broad influence of the COVID-will extend that ranking for
years to come. Specifically, they anticipate that the global burden of
cardiovascular disease will grow exponentially over the next few years, as
part of the evolving long-term effects of coronavirus. Naturally, this means
that heart health is among the top public health concerns for physicians
and public health workers today.

 HIV

There have been enormous strides made in the treatment and prevention
of HIV, but there are still millions who die each year from HIV/AIDS. As
COVID-19 vaccines were being developed in 2020, many health experts
warned that vaccines can take years to come to fruition. The most popular
comparison was made with the promised vaccine for HIV many years ago.
To this day, there is no vaccine that helps prevent the virus or treat those
infected. Scientists continue to work to develop an HIV/AIDS vaccine.

According to the WHO, more than 70 million people have contracted the
infection since the epidemic first broke out, and about 33 million have died
as a result. Today, there are around 38 million people living with HIV who
may need support. Approximately 1.2 million Americans are living with HIV
in the U.S. today, and about 14 percent of them – that’s 1 in 7 – don’t know
it and need testing.

 Motor Vehicle Injuries

Distracted driving, drunk driving, and vehicle safety are among the top
concerns for safety on the road, according to the National Highway Traffic
Safety Administration. As a result, policies surrounding seatbelt usage,
proper car seat installation and usage, and driver’s license testing continue
to be ranked among the top public health concerns.

 Nutrition, Physical Activity, and Obesity

Our nutrition and physical activity is another public health issue that has
only been amplified by the COVID-19 pandemic. This was among the top
public health problems before the outbreak of the novel coronavirus – with
the CDC reporting obesity effects 93.3 million American adults and more
than 13.7 million children – but those numbers will likely grow significantly
in the near future. A global study, published in the journal Obesity, found
that lockdowns related to the pandemic led to dramatic changes in health
behaviors, prompting people around the world to cut back on physical
activity and eat more junk foods.

This is a serious health concern for public health professionals, since

obesity increases the risk of chronic illnesses like diabetes, blood pressure,
and heart disease. Obesity is also considered a high-risk factor for COVID-19.

The good news is that, over the years, the rise of obesity has led to more
awareness and education surrounding proper nutrition and physical activity.
Public health educators have been paving the way for better nutrition and
deepened self-care in communities.

 Teen pregnancy
While the rate of teen pregnancy continues to decrease every year, almost
250,000 babies were born to females ages 15-19 in 2014. Teens need
support from parents and other trusted adults, who can play an important
role in helping them make healthy choices about relationships and sexual
activity, the CDC advises.

About Teen Pregnancy

The US teen birth rate (births per 1,000 females aged 15 to 19 years) has
been declining since 1991.  Teen birth rates continued to decline from 17.4
per 1,000 females in 2018 to 16.7 per 1,000 females in 2019.  This is
another record low for US teens and a decrease of 4% from 2018.Birth
rates fell 7% for females aged 15 to 17 years and 4% for females aged 18
to 19 years.
Although reasons for the declines are not totally clear, evidence suggests
these declines are due to more teens abstaining from sexual activity, and
more teens who are sexually active using birth control than in previous
years.

Still, the US teen birth rate is substantially higher than in other western
industrialized nations, and racial/ethnic and geographic disparities in teen
birth rates persist.

Disparities in Teen Birth Rates

Teen birth rates declined from 2018 to 2019 for several racial groups and
for Hispanics. Among 15- to 19-year-olds, teen birth rates decreased:

 5.2% for Hispanic females.

 5.8% for non-Hispanic White females.
 1.9% for non-Hispanic Black females.
Rates for non-Hispanic American Indian/Alaska Natives (AI/AN), non-
Hispanic Asians, and non-Hispanic Native Hawaiian, and other Pacific
Islander teenagers were unchanged.

In 2019, the birth rates for Hispanic teens (25.3) and non-Hispanic Black
teens (25.8) were more than two times higher than the rate for non-
Hispanic White teens (11.4). The birth rate of American Indian/Alaska
Native teens (29.2) was highest among all race/ethnicities.
Birth Rates for Females Aged 15 to 19 Years, by Race and
Hispanic Origin of Mother: United States, 2018 and 2019

 Prescription Drug Overdose

The drug overdose epidemic – primarily driven by opioid abuse – has killed
more than 750,000 people since 1999. Two out of three of the drug
overdose deaths in 2018 involved an opioid. In 2017, the U.S. Department
of Health and Human Services declared the opioid epidemic a public health
emergency and announced a strategy to help combat the problem.

As noted above, experts are seeing a rise in substance abuse and drug
overdoses since the COVID-19 pandemic began. Lockdown orders have
increased feelings of boredom, which in turn has increased the risk of
substance abuse. In addition, with many people at home alone, there is a
higher risk of overdosing without anyone knowing or being there to call for
help.

 Air Pollution Is another

Climate change is projected to harm human health by increasing ground-

level ozone and/or particulate matter air pollution in some locations.
Ground-level ozone (a key component of smog) is associated with many
health problems, such as diminished lung function, increased hospital
admissions and emergency room visits for asthma, and increases in
premature deaths. Factors that affect ozone formation include heat,
concentrations of precursor chemicals, and methane emissions. Particulate
matter concentrations are affected by wildfire emissions and air stagnation
episodes, among other factors. By increasing these different factors,
climate change is projected to lead to increased concentrations of ozone
and particulate matter in some regions. Increases in global temperatures
could cause associated increases in premature deaths related to worsened
ozone and particle pollution.
  Climate Effects on Health

Climate change, together with other natural and human-made health

stressors, influences human health and disease in numerous ways. Some
existing health threats will intensify and new health threats will emerge. Not
everyone is equally at risk. Important considerations include age, economic
resources, and location.

In the U.S., public health can be affected by disruptions of physical,

biological, and ecological systems, including disturbances originating here
and elsewhere. The health effects of these disruptions include increased
respiratory and cardiovascular disease, injuries and premature deaths
related to extreme weather events, changes in the prevalence and
geographical distribution of food- and water-borne illnesses and other
infectious diseases, and threats to mental health.

 Allergens and Pollen

Climate change will potentially lead to both higher pollen concentrations

and longer pollen seasons, causing more people to suffer more health
effects from pollen and other allergens.

Pollen is an airborne allergen that can affect our health. Pollen grains are
tiny “seeds” dispersed from flowering plants, trees, grass, and weeds. The
amount and type of pollen in the air depends on the season and
geographic region. Though pollen counts are typically higher during the
warmer seasons, some plants pollinate year-round.

Climate change will potentially lead to shifts in precipitation patterns, more

frost-free days, warmer seasonal air temperatures, and more carbon
dioxide (CO2) in the atmosphere. These changes can affect:

 when the pollen season starts and ends and how long it lasts each
year,
 how much pollen plants create and how much is in the air,
 how pollen affects our health (the “allergenicity” of pollen),
 how much pollen we’re exposed to, and
 our risk of experiencing allergy symptoms.
Pollen exposure can trigger various allergic reactions, including symptoms
of hay fever. Hay fever, also known as allergic rhinitis, occurs when
allergens like pollen enter your body and your immune system mistakenly
identifies them as a threat. If you have allergic rhinitis, your body then
responds to the allergen by releasing chemicals that can cause symptoms
in the nose. Symptoms of allergic rhinitis can occur during certain seasons
or year-round, depending on the allergen, and affect as many as 60 million
people per year in the United States. Symptoms from allergic rhinitis
include sneezing, runny nose, and congestion.

Pollen exposure can also trigger symptoms of allergic conjunctivitis.

Allergic conjunctivitis is the inflammation of the lining of the eye
(conjunctiva) due to exposure to allergens like those in pollen. Allergic
conjunctivitis is found in up to 30% of the general population and as many
as 7 out of 10 of patients with allergic rhinitis. Symptoms from allergic
conjunctivitis include red, watery, or itchy eyes.People with respiratory
illnesses like asthma may be more sensitive to pollen. Exposure to pollen
has been linked to asthma attacks and increases in hospital admissions for
respiratory illness. Medical costs linked with pollen exceed $3 billion every
year, with nearly half of those costs being linked to prescription medicine.
Higher pollen concentrations and longer pollen seasons can also make you
more sensitive to allergens. This can trigger asthma episodes in individuals
with asthma and diminish productive work and school days.

Extreme rainfall and rising temperatures also can contribute to indoor air
quality problems. For example, they can cause the growth of mold indoors,
which may lead to worsened respiratory conditions for people with asthma
and/or mold allergies and heightened challenges in maintaining adequate
asthma control

 Homelessness Is another a Public Health Issue

There is a public health crisis playing out on the streets of our nation’s
communities. Homeless men and women, many living with disabling
conditions, are joining a declining, though still significant, population of
what many refer to euphemistically as “the unsheltered” or “forgotten”
homeless. The significant economic and moral dimensions of
homelessness come into sharper focus when those living on our streets
once defended our nation. Veterans are at greater risk of experiencing
homelessness than other adults. The reasons for this are not all related to
military service; however, combat, wartime trauma, and posttraumatic
stress disorder (PTSD) sometimes contribute to a downward spiral of
depression, substance abuse, broken relationships, unemployment, and
isolation -which may lead to homelessness. Set against this humbling
backdrop are our remarkable and ambitious national goals to end veteran
and chronic homelessness once and for all. Leadership counts, and the
President of the United States has been unwavering in resourcing the
initiatives we describe here. Central to achieving these goals is a growing
shift toward intervention that is data driven, is research informed, and
prioritizes more immediate access to permanent housing. One such model
is Housing First, an emerging, evidence-based best practice for assisting
people experiencing chronic homelessness to obtain and maintain
permanent housing-quickly, safely, and without prerequisites. Additionally,
the Housing First model also assists with access to health care,
employment, and other supportive services that promote long-term housing
stability, reduce recidivism, and improve quality of life. Investments in
effective, evidence based programs utilizing the Housing First model, such
as rapid rehousing, Supportive Services for Veteran Families (SSVF), and
the Housing and Urban Development Veterans Affairs Supportive Housing
 (HUDVASH) programs, along with unprecedented partnerships between
federal and local partners, have yielded substantial reductions in veteran
and chronic homelessness.

 Top public health problems for the modern age

Despite the rapid advancement of medical treatments and technologies,

there are still many public health problems plaguing industrialized nations
around the world. According to a 2018 report from the CDC, the life
expectancy for the U.S. population declined to 78.6 years in 2017 (Centers
for Disease Control and Prevention, 2018). The leading causes of death,
which accounted for 74% of all mortalities, included:

 Heart disease
 Cancer
 Unintentional injuries
 Chronic lower respiratory diseases
 Stroke
 Alzheimer’s disease
 Diabetes
 Influenza and pneumonia
 Kidney disease

While these specific causes represent key public health concerns, there are
a variety of medical issues and behaviors that contribute to their growing
mortality rates. For example, individuals who are not physically active are
often at higher risk of heart disease, stroke, and diabetes (American Heart
 Association, 2016). As such, raw statistics rarely paint a complete picture of
health issues in America, which is why the CDC focuses on prevention-
based initiatives and education programs. With that in mind, here are 5 of
the top public health problems the CDC is currently tracking, both at home
and abroad.
 Heart disease and stroke

 Heart disease is currently the leading cause of death both in the U.S. and
worldwide. On average, someone dies from cardiovascular disease every
38 seconds, which is around 2,303 deaths per day (Centers for Disease
Control and Prevention, 2019). The term “heart disease” is actually used to
describe several different conditions, many of which relate to the buildup of
plaque in a person’s arteries or irregular heart rhythms. Unlike infectious
diseases, this public health problem is highly preventable and the risk
factors are well understood by medical professionals. Heart disease
 Cancer
 Unintentional injuries
 Chronic lower respiratory diseases
 Stroke
 Alzheimer’s disease
 Diabetes
 Influenza and pneumonia
 Kidney disease:

 Tobacco use
 Physical inactivity
 Poor nutrition
 Obesity
 Stroke is another possible outcome of poor heart health, leading to an
average of 389.4 deaths each day (American Heart Association, 2019). Of
course, congenital conditions can increase a person’s chances of
experiencing a heart attack or stroke, but staying active and eating healthy
are essential for managing most cardiovascular diseases.
 Health organizations have been working to reduce the rate of heart disease
for decades, mostly through public awareness initiatives and improved
screening programs. Despite their efforts, the health care costs associated
with cardiovascular disease are projected to exceed $1 trillion by 2035 (RTI
International, 2017). To help control these expenses, the CDC has
recommended promoting team-based care and clinical decision-support
systems focused on prevention and heart.

EMERGING HEALTH ISSUES THE CHALLENGES FOR HEALTH

PROMOTION

In sum, global and regional inequality, narrow and outdated economic

theories and an ever-nearing set of global environmental limits endanger
population health. On the positive side of the ledger, there have been some
gains (e.g. literacy, information sharing and food production, and new
medical and public health technologies continue to confer large health
benefits). Overall, though, reliance on economic, especially market-based,
processes to achieve social goals and to set priorities and on technological
fixes for environmental problems is poorly attuned to the long-term
improvement of global human well-being and health. For that, a
transformation of social institutions and norms and, hence, of public policy
priorities is needed.
Population health can be a powerful lever in that process of social change,
if health promotion can rise to this challenge.

Many of these contemporary risks to population health affect entire

systems and social–cultural processes, in contrast to the continuing health
risks from personal/family behaviors and localized environmental
exposures. These newly recognized risks to health derive from
demographic shifts, large-scale environmental changes, an economic
system that emphasizes the material over other elements of wellbeing and
the cultural and behavioral changes accompanying development.

Together, these emerging health risks present a huge challenge to which

the wider community is not yet attuned. The risks fall outside the popular
conceptual frame wherein health is viewed in relation to personal
behaviors, local environmental pollutants, doctors and hospitals. In
countries that promote individual choice and responsibility, there are few
economic incentives for the population's health.

Health promotion must, of course, continue to deal with the many local and
immediate health problems faced by individuals, families and communities.
But to do so without also seeking to guide socio-economic development
and the forms and policies of regional and international governance is to
risk being ‘penny wise but pound foolish’. Tackling these more systemic
health issues requires multi-sectorial policy coordination at community,
national and international levels, via an expanded repertoire of bottom-up,
top-down and ‘middle-out’ approaches to health promotion.
 CONCLUSION

However, today's health promotion challenge extends that foreseen in 1986

and requires work at many levels. There is need for proactive engagement
with international agencies and programs that bear on the socio-economic
fundamentals in disadvantaged regions/countries. Many low- and middle-
income countries require financial aid from donor countries to achieve the
health-related MDGs, to deal with emerging and re-emerging infectious
diseases and to counter the emerging health risks from human-induced
global environmental problems. Linkages between the health sector and
civil society, including those struggling to promote development, human
rights, human security and environmental protection, should be
strengthened.
We need to understand that ‘sustainability’ is ultimately about optimizing
human experience, especially well-being, health and survival. This requires
changes in social and political organization and in how we design and
manage our communities. We must live within the biosphere's limits. Health
promotion should therefore address those emerging population health
influences that transcend both national boundaries and generations. The
central task is to promote sustainable environmental and social conditions
that confer enduring and equitable gains in population health.

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