Top public health issues of 2012

By Michael Yudell and Jonathan Purtle

Approximately 3.9 million babies will fondly recall 2012 as the year they were born in the United States. The year will hold a special place in their hearts for an estimated 78.5 years—the average life expectancy at birth in the U.S. Their chances of living beyond that estimate, and their quality of life as they age, will be greatly influenced by the issues that we write about on this blog—the issues which fall within the purview of public health.  Here are some of the top public health issues that we, and perhaps a cohort of 3.9 million, will think of when we reflect back on 2012.

Fracking: While not an animal in the Chinese zodiac, 2012 was the year of the guinea pig in Pennsylvania.  As The Public's Health's expert panelist Bernard Goldstein described, Pennsylvania has volunteered to serve as the proverbial guinea pig of the Marcellus Shale natural gas extraction experiment.  Limited regulatory oversight, tax incentives, and an absence of research have allowed for the practice of hydraulic fracking to generate quick state revenue while its health consequences remain "inconclusive." Like a guinea pig in a scientific experiment, however, Pennsylvania is taking on extraordinary risk for short-term gains.   Neighboring states, which are exercising more caution in their fracking decisions, are likely to benefit from the knowledge that results from Pennsylvania's fracking experiment.

Violence: An estimated 16,000 people died from interpersonal violence in the U.S. in 2012—most of them youth.  While coordinated efforts to prevent the community violence which plagues many U.S. cities are lacking, the tragic mass shootings in Aurora, Colorado and Newtown, Connecticut have catapulted the issue of violence to the forefront of political agenda. What real change will come from this sudden burst of attention? Time will tell.  To be sure, discussions about tradeoffs between public safety and individual liberty and the role of collective responsibility for identifying and addressing mental illness will be central to any meaningful action.

Child Protection: On the heels of the Penn State atrocities which came to light in late 2011, 2012 was ushered in with great concern about the health and well-being of children.  The American Academy of Pediatrics issued a policy statement and technical report on the effects of toxic stress, trauma, and adversity in childhood.  The Centers for Disease Control and Prevention released estimates of the financial costs associated with a single case of child maltreatment—over $210,000.  As scientific evidence continues to demonstrate that ensuring safe, supportive environments for children is critical to the vitality our society, it might be time to bring back the United States Children's Bureau in 2013.

Climate Change: In the wake of record hot temperatures and drought across the U.S. this summer, it is true that more Americans Americans now believe that the climate is changing, up from a low of fifty-two percent in 2010. But that hasn't stopped climate change denialists from trying, well, find new and creative ways to deny the impact of our changing world. North Carolina, for example, passed a law this year that would ban scientists from accurately measuring the rising seas along the Carolina coast. Never mind a report that pointed to an already increasing death toll world-wide from changes to our climate.

The Affordable Care Act: The Supreme Court's 5-4 decision upholding most of the Affordable Care Act was the biggest court decision of the year, one with an outsized impact on the public health. As President Obama put it in 2009, providing near-universal coverage for Americans is "a core ethical and moral obligation." The moral foundations of health care didn't stop some from wondering whether Justice John Roberts' vote to uphold the ACA was due to a lack of "intestinal fortitude" or cognitive problems brought on by anti-seizure medication. Obamacare may be here to stay, but there are still significant challenges ahead implementing the ACA.

2013 is sure to bring more public health challenges, and we look forward to covering them in the coming year. A happy and health new year from Michael and Jonathan at The Public's Health.

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