Declining Life Expectancy & the Power of Public Health

Two years ago, in the face of grim news that life expectancy in the United States was declining, Bloomberg Philanthropies gave the Johns Hopkins School of Public Health a transformational gift to create the Bloomberg American Health Initiative. The goal was straightforward but daunting: use the tools of public health to address some of the issues that are driving the decline: Addiction and overdose, Environmental Challenges, Obesity and the Food System, Risks to Adolescent Health, and Violence.

Now, in collaboration with Public Health Reports, the scholarly journal of the U.S. Surgeon General, the Initiative has published a journal supplement that takes an in depth look at the five focus areas and provides a road map for how public health and other sectors can work to tackle these challenges.

The journal supplement features five peer-reviewed articles – one in each area – that “provide a road map for efforts to bring public health training to frontline organizations, pursue insights through innovative research, and advance effective programs, policies, and strategies for change,” according to a commentary from the issue’s guest editors.  The supplement also features commentaries by leaders in public health describing the importance of key public health tools of equity, evidence, and policy in addressing these issues.

The supplement’s guest editors are Bloomberg School Dean Ellen J. MacKenzie, PhD, MSc, Vice Dean and Director of the Bloomberg American Health Initiative Joshua M. Sharfstein, MD, Dean Emeritus Alfred Sommer, MD, and Jessica Leighton, PhD, from Bloomberg Philanthropies.

Highlights of the special PUBLIC HEALTH REPORTS supplement include:

• Brendan Saloner, PhD, assistant professor in the Bloomberg School’s Department of Health Policy Management, and colleagues provide a public health perspective on the opioid epidemic, writing “Public health has an important role in helping to understand why people use drugs, offering less stigmatizing strategies to assist people who use opioids, and disseminating innovative programs that help these populations to safely use drugs, receive treatment, and enter long-term recovery. Ultimately, overdose deaths are preventable, lives can be saved, and people can recover, regain stability, and have productive futures.”

• Kirsten Koehler, PhD, associate professor in the Department of Environmental Health and Engineering, and colleagues set out critical steps to improve environmental health, stating “Achieving a healthy environment will require a more holistic view than the current regulatory approaches. We must move beyond regulating smokestacks and discharge pipes toward an inclusive consideration of the role of the built environment in environmental quality and public health. 

• Anne Barnhill, PhD, research scholar with the Global Food Ethics and Policy Program at the Berman Institute of Bioethics, and colleagues make the case for a systems approach to addressing the obesity epidemic, writing “New approaches are needed to reduce the rates of obesity and minimize the unintended consequences of interventions in U.S. food systems. The public health tools needed to do this—policies, local programs, and research—should be reconceptualized so they work at multiple levels, including individual, family, community, and societal levels, as well as for localities, nations, and the global community.

In addition, Lisa Cooper, MD, Bloomberg Distinguished Professor in the Department of Health, Behavior and Society, and colleagues call for broad consideration of equity in addressing health challenges. Professor Keshia Pollack Porter, PhD, professor in the Department of Health Policy and Management, and colleagues write about the critical role policy can play in improving health, and Kevin Callahan, PhD, and Elizabeth Stuart, PhD, associate dean for education at the Bloomberg School, provide a framework for greater use of data in guiding policies and programs.

The full supplement is available for download. You can also listen to an American Health Podcast interview with Dr. Sharfstein about the supplement and the Bloomberg American Health Initiative.