08. Smetana US Public Health Priorities Hanoi Sept 2012

United States Public Health: Life Expectancy Leveling Off Source: CDC 5... Why is Life Expectancy Leveling Off?. Smoking Statistics in the U.S.: Sadly, Still a Major Problem  More death

1. Hypertension

2. Upper respiratory

infections (“colds”)

3. Arthritis

4. Diabetes

5. Back pain

6. Prenatal care

7. Routine check up

8. Cancer

9. Arthritis

10. Heart disease

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Rank Cause of Death Death Rate per 100,000

1 Heart disease 195

5 Accidental death 38

6 Alzheimer's Disease 26

8 Influenza and pneumonia 18

9 Kidney disease 16

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United States Public Health: Life

Expectancy Leveling Off

Source: CDC 5

Why is Life Expectancy Leveling Off?

Preventable Causes of Death in the U.S.

Daniels et al, PLoS 2009

Where Do We Stand in 2012? Only 32%

of Americans Are at a Healthy Weight

Obesity, 33.90%

Overweight, 34.40%

Healthy, 32.10%

Obesity Overweight Healthy

Smoking Statistics in the U.S.:

Sadly, Still a Major Problem

 More deaths each year due to tobacco use than by all deaths from HIV, illegal drug use, alcohol use, motor vehicle injuries, and suicides combined

 443,000 deaths annually

 Adults who smoke cigarettes die an average of 14 years earlier than nonsmokers

 Men who smoke increase their risk of dying from COPD by nearly 10 times and from lung cancer by more than 22 times

Source: U.S CDC, 2012 Data

 46 million American have no health insurance

 1/3 of all American have a major chronic illness

 1/5 of Americans still smoke cigarettes

 2/3 of Americans are overweight or obese

 An increasing shortage of primary care (general

medical) doctors even in major cities

 Impending primary care crisis?

 Aging population post “baby boom”

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 Low income compared to other specialties

 High debt load of graduating medical students

 Challenge to remain competent in many different

areas of expertise (i.e heart disease, cancer,

prevention, etc)

 Less prestige

 Exhaustive amounts of paperwork and insurance

forms

 Long and unpredictable hours

 1/3 of physician workforce but 2/3 of all office visits 11

 Improve access to care

 Eliminate health disparities linked to ethnicity and

socioeconomics factors

 Strengthen the public health infrastructure

 Increase investment in efforts to prevent disease,

injury, and disability

 Increase investment in public health research

 Strengthen American leadership and investment in global health

Assoc of Schools of Public Health 2011 12

Six Key U.S Public Health Priorities

 Improve payment for general medical office

visits

 Loan forgiveness for medical students who

become general medical doctors

 Increase healthy eating habits and reduce

obesity rates

 Penalties to encourage cigarette cessation

 Reduce the number of uninsured Americans

 Reduce time for generic medication availability

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Thank You

 I also wish to thank Dr Ha Phan Hai An who has been a gracious and talented course co-director

 Thanks to my colleagues at Hanoi Medical

University for making our novel collaborative

education concept work

 Thanks to the people and government of

Vietnam for your kindness, and for your support

of high quality medical education

 I hope to see many of you again next year

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