The Public's Health: The Story We Are Not Talking About Enough | Public Health Post

In 1918, a pandemic of Spanish flu infected approximately one third of the global population, killing between 20 and 50 million people. In the United States alone, more than 650,000 people died, enough to contribute to a decline in the country’s life expectancy. For a century, this was the worst decline in American health. Until this year. The National Center for Health Statistics reported that, between 2016 and 2017, US life expectancy dropped from 78.7 to 78.6 years. This marks the third consecutive year that life expectancy in the US has decreased.
We have not had a drop like this since the 1918 flu pandemic. What does our lack of attention tell us about how we think about health in this country?
One possibility it that we simply don’t know about these data. Perhaps we should have news headlines, “Our national health has taken a turn for the worse,” appear regularly until we reverse this trend.
Or perhaps we have come to accept the longer-term trend in which US life expectancy has lagged relative to other economically comparable countries. Perhaps knowing that our health is not terrific is simply the American condition. But, of course, it is not and our health was not always worse than our peer countries. As recently as thirty years ago we were in the top half of the pack.
Or perhaps we think that our collective national problems with health—addiction and suicide are the notable crises driving our falling life expectancy—are not my problem. If we spend enough money on our health, each of us is going to be fine.
Or perhaps we don’t know how to correct this slippage in life expectancy. We see the problem as too large, beyond our control, untenable.
If we continue to accept our collective poor health, it is in part because we are not paying attention to health the way we should be, and it is in part because we have accepted changes in the past 30 years—such as growing levels of income inequality—that have made our health worse. In the end, poor health for some will affect the health of many of us. Our chances of getting infectious diseases, of being a killed by a car while walking, of developing asthma due to secondhand smoke, all depend on the health of others around us.  
Shouldn’t we then start paying attention to the worst American health deterioration in a 100 years?

Michael Stein & Sandro Galea