When I first came to public health, I felt like many of my young, idealistic peers. The public health system in the United States was on a path to eradicate cancer, prevent disease and improve lives. Our democracy would lead to a healthy population for all and I would be part of securing a healthy future for my kids and grandkids. I am now in my 30th year in public health. I am confronted with a sobering reality that with all the advances in medicine, our health outcomes need a lot of work.
Currently, the average life expectancy for a white person in the U.S. is 78 years. It really isn’t bad until you think that there are 26 countries that have better longevity than the U.S. We have the same life expectancy of Slovenia and Costa Rica. If you looked at some minorities in the U.S., it could be worse. Americans have shorter lives than expected based on income. If you looked at other countries and used their life-to-per capita-income ratio, we should be living to 80.4 years of age.
I know that health is subject to choices people make, but we are all interconnected. It is our duty in society to build in support to help foster better choices and discourage unhealthy ones. One support is to invest in health policy and programs. Simply put: You get what you pay for. Missouri is 51st in state public health funding. The butcher’s bill is now coming due and individual poor health choices are now collectively driving up health care costs and draining resources. The growing rhetoric of, “just cut some of the entitlement services,” isn’t going to work. It is time to become penny wise – not dollar foolish.
With youthful illusions shattered – it is time to dream bigger. John F. Kennedy once said, “All this will not be finished in the first 100 days. Nor will it be finished in the first 1,000 days, nor in the life of this Administration, nor even perhaps in our lifetime on this planet. But let us begin.” I would like to be so bold as to improve upon Kennedy’s wisdom with the addition of 2 words: “But let us begin…” with prevention. It is time to pick up the pieces of shattered illusions and begin again.