Twelve Leading Public Health Concerns

Although they don’t receive as much attention as rising healthcare premiums or drug breakthroughs tend to, public health concerns that affect communities at large are among the biggest challenges on the nation’s healthcare landscape.

Public health professionals in the United States are working to remedy and prevent these 12 important health concerns:

1. OBESITY

‘Overweight’ and ‘obese’ are terms which the World Health Organization (WHO) defines as “abnormal or excessive fat accumulation that presents a risk to health.”¹ The Centers for Disease Control and Prevention (CDC) notes that Body Mass Index (BMI) is a screening tool used to identify these conditions: It’s found by dividing a person’s weight in kilograms by the square of height in meters. With a BMI of 25-29.9, a patient is called overweight, while a BMI of 30 or more qualifies that person as obese.²

Obesity is linked to significantly increased risk of chronic health conditions, including type 2 diabetes, heart disease and cancer. According to the CDC, approximately 73.6 percent of adults in the U.S. meet definitions for overweight or obese. Obesity also has a high economic cost with an annual medical cost estimated at $173 billion.³

2. HYPERTENSION

Hypertension, commonly known as high blood pressure, affects 47 percent of adults in the U.S. and can lead to medical emergencies such as heart attack and stroke.⁴ It is often labeled as ‘the silent killer’ because there aren’t any early symptoms of the disease.⁵

Blood pressure is the pressure of blood pushing against the walls of your arteries that carry blood from your heart to other parts of your body. It can occur as a result of genetics, unhealthy diet, and lack of physical activity. Other health conditions, such as obesity and diabetes, can also increase a person’s risk of developing high blood pressure, while eating a healthy diet and exercising regularly can help lower blood pressure.⁶

3. HEART DISEASE AND STROKE

Heart disease is the leading cause of death for men and women across almost every racial and ethnic group in this country, killing more than 697,000 Americans each year. The financial costs of heart disease are estimated at $229 billion a year for medications, treatment, and lost productivity due to premature death.⁷ High blood pressure, a leading cause of heart disease, is also linked to a higher risk of experiencing a heart attack or stroke.⁸

4. TYPE 2 DIABETES

Type 2 diabetes is a chronic condition that affects how the human body processes glucose (blood sugar). In 2019 an estimated 37.3 million Americans—11.3 percent of the total population—had type 2 diabetes. Another 96 million Americans have pre-diabetes,⁹ which can lead to diabetes if no lifestyle changes or other interventions are put into effect. In 2017, the disease was responsible for $237 billion in direct medical costs and $90 billion in reduced productivity. Even after adjusting for differences in age and sex, healthcare costs for someone with diabetes are 2.3 times higher than for someone without it.¹⁰

5. DEPRESSION AND ANXIETY

Mental health is a significant public health issue, and resources to address it are limited in almost every community nationwide. Around 40 million adults experience anxiety, making it the country’s most prevalent mental health disorder. Major Depressive Disorder (MDD) affects 16 million adults, and many experience MDD and anxiety.¹¹ The costs of poor mental health are hard to quantify, but studies have shown that it can have adverse effects on ‘critical development transitions,’ including marriage, educational attainment, childbearing, and the ability to get and maintain employment. This can have far-reaching consequences in terms of financial security, social support, and other health indicators.¹²

6. PRESCRIPTION DRUG ABUSE

In the United States between 1999 and 2020, the number of drug overdose deaths quintupled. Nearly 75 percent of those deaths involved an opioid. Interestingly, heroin-involved death rates decreased by 7 percent between 2019 and 2020 while prescription opioid-involved death rates increased by 17 percent and synthetic opioid-involved death rates (excluding methadone) increased by 56 percent. The CDC now pinpoints three waves of opioid deaths, beginning in the 1990s when opioids were increasingly prescribed. The second wave began in 2010 with more deaths being related to heroin, and the third wave began in 2013 with a significant increase in deaths involving synthetic opioids like fentanyl.¹³ Evidence-based initiatives to curb opioid abuse include targeted Naloxone distribution, medication-assisted treatment, Good Samaritan Laws and Syringe Services Programs.¹⁴

7. ALCOHOL AND TOBACCO USE

Tobacco use in any form is linked to chronic health conditions such as heart disease, stroke and cancer, and can lead to premature death. After decades of decline in the U.S., it’s once again on the rise after the commercial introduction of e-cigarettes. In an alarming trend, teen e-cigarette usage almost doubled from 2017 to 2018, increasing from 11.7 percent to 20.8 percent in just a year.¹⁵

Excessive alcohol consumption also has significant health consequences, negatively affecting the brain, heart, liver, and pancreas. Chronic liver disease and cirrhosis from alcohol use affect approximately 4.5 million people in the U.S. and is the cause of 56,585 deaths each year.¹⁶ Alcohol use is a risk factor for multiple cancers, including head and neck cancer, breast cancer, colorectal cancer, and liver cancer.¹⁷

8. DISTRACTED DRIVING

Motor vehicle accidents have long been a source of premature death and a recurring public health concern. An increase in vehicle safety features, such as seatbelts and airbags, has reduced injuries and fatalities, but distracted driving—especially during smartphone use—continues to be a significant problem, contributing to 3,522 fatalities in 2021.¹⁸ Many states have enacted strict laws to punish distracted drivers and reduce the harm they often cause: 31 states, the District of Columbia, and all four U.S. territories ban handheld cellphone use, 36 states ban cellphone use for novice drivers, and 48 states ban texting while driving.¹⁹

9. FOOD SAFETY

Foodborne illness affects about 1 in 6 people every year, resulting in more than 100,000 hospitalizations and 3,000 deaths. As the food supply in the U.S. increasingly comes from large farms and production facilities that ship around the country, foodborne illness is likely to remain a problem but it can be combated by interventions in food production, processing and storage.

10. ANTIBIOTIC RESISTANCE

Every year, 2.8 million people in the U.S. contract an antibiotic-resistant infection. Fighting this public health challenge requires a concerted effort by infectious disease experts, medical professionals, and patients to limit unnecessary use of antibiotics. Overprescribing antibiotics or using them in situations where they do not help (to treat viruses, for example) allows microbes to adapt and strengthen, limiting an effective anti-infection tool.²¹

11. AIR POLLUTION

Air pollutants present a significant and growing health hazard. Household combustion devices, motor vehicles, industrial facilities and forest fires are common sources of air pollution. . . ²² While air pollution can affect anyone, it takes a larger toll on low-income communities, where people are more likely to live near pollution sources, have less access to healthcare, and live at higher risk of developing other chronic health conditions, such as asthma or heart disease, which are exacerbated by air pollution.²³

12. SPREAD OF COMMUNICABLE DISEASES

Efforts to curb communicable disease date back at least to the 1600s, when European cities appointed public health officials to enforce quarantine measures during The Plague.²⁴ COVID-19 is the biggest pandemic outbreak in over 100 years, but every year, public health professionals fight against communicable disease pandemics such as influenza, which results in hundreds of thousands of deaths worldwide, as well as other smaller outbreaks that don't reach pandemic status.²⁵ The American Public Health Association's Control of Communicable Diseases Manual lists more than 200 diseases, including malaria, Zika, and Ebola. Public health officials work to prevent their spread by promoting sanitation and vaccination.²⁶

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