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Emerging
Issues
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| The North Carolina
2010 Health Objectives document is intended to be a working, living
document designed to evolve over the decade. At the beginning of a
new decade, it is difficult to predict what changes will occur over
the next ten years. North Carolina, like the rest of the nation, is
evolving rapidly. The population is growing older and becoming more
diverse. Technology is changing education, as well as business, healthcare,
and all other systems of everyday life. At the end of the decade,
there will be new jobs that are not even imagined today. The workforce
is constantly evolving to acquire the new skills needed for these
new jobs. New diseases are emerging and challenging science and the
healthcare system. The national government may continue to devolve
many responsibilities to the state and local governments.
The Governor’s Task Force for Healthy
Carolinians has attempted to look ahead and imagine the year 2010
as they developed the health objectives contained in this document.
Following the guidance from the Chair, the objectives have adhered
to the standards that they: (1) be measurable and backed by data
that will be available over the decade to monitor the objectives;
(2) be ambitious and achievable, and (3) respond to the key health
and safety issues in North Carolina. During the yearlong process
of developing the health objectives, several issues were brought
to the attention of the Governor’s Task Force. However, because
they did not comply with the standards, they could not be included
as an objective.
These issues are critical and important
and will impact the health of North Carolinians over the next decade.
Therefore, this chapter will highlight these emerging issues and
follow them over the decade. In each of the areas below, it is unclear
what role public health and the healthcare system will play. Certainly,
as science brings these issues into focus, public health and the
healthcare community will work together to respond appropriately.
The public health infrastructure must
be ready to respond to these new emerging threats. State-of-the-art
technology and highly skilled professionals need to be in place
to provide rapid response to threat of epidemics. Coordinated strategy
is necessary to understand, detect, control, and prevent infectious
diseases.
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1.
Alternative Medicine
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Interest in alternative healthcare has been
growing at a phenomenal rate. Each year, Americans spend millions
of dollars for vitamins, food supplements, and alternative therapies
to augment the traditional healthcare provided by doctors, clinics,
and hospitals. There are many reasons for this increased interest
in alternative healthcare The most common reasons is the increasing
desire on the part of individuals to take a more active role in improving
and maintaining their own health and well-being. This new arena of
healthcare has several labels: Alternative Medicine, Holistic Medicine,
Expanded View of Health, Integrative Medicine, and Complementary Medicine.
All of the therapies that fall into alternative healthcare have an
underlying tenet that wellness and healing must focus on the entire
individual and his/her surroundings – rather than just the symptoms
or the underlying disease. The linkage between the mind-body-spirit
is fundamental in these approaches. Herbs, vitamin/mineral supplements,
and other dietary additives/practices are woven throughout most alternative
heath care practices.
The role of public health and the healthcare
system in alternative healthcare has not been determined. At this
time, very little research has been done on the benefits of these
therapies. Much discussion is needed to clarify public health’s
role in alternative healthcare. Some think that public health’s
role would be to provide education and information about precautions
and benefits of using natural products, herbs, vitamins, and natural
healing foods; about the role of self-care (normal routines for
self-care, etc.); and about "self-defense prevention."
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2.
Genomics
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Biotechnical advances will rapidly occur
after the human genome is completely mapped. Various disease patterns
and markers will be identified and this information will revolutionize
medicine and public health. There will be implications for screening,
vaccinations, prevention, detection, and early treatment of a myriad
of conditions from the simple to the serious. Additional problems
and conditions that aren’t well understood today will be unlocked
and for the first time, medicine and public health will begin to address
these health concerns. Ethical issues surround this new information
will be debated over the coming decade. The public’s health will
be greatly affected by this new information.
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3.
Environment
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Environmental
changes will have a tremendous impact on the public’s health.
Already, respiratory diseases, such as asthma, are on the increase
because of air pollution. Climate changes, such as global warming,
are resulting from human activity. Changing the topography, for example
paving over wetlands, changes entire ecosystems, threatening the existence
and diversity of many plant and animal species. Extreme weather, such
as hurricanes and floods, also change the environment. Agribusiness
and other industries threaten the quality of the air, water, and soil.
While much of the environment is regulated by federal law, it will
still be the goal of each state and county to educate its citizenry
about the effects these environmental challenges have on health and
well-being. Human behavior, as well as businesses, will be asked to
change to assure that the air, water, and soil remain clean enough
to sustain quality of life.
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4.
Technology
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In the future technology will impact every aspect
of life; healthcare is no exception. Advances in technology will change
how medicine is practiced in the clinic and in the hospital. Already
through technology, new methods for screening, diagnosis, and surgery
are being implemented, saving thousands of lives. The Internet is
critical to supporting healthcare. The Internet enables cutting-edge
information to be available to all healthcare providers, as well as
health education available to individuals. Access to the Internet
and technology will be critical for all populations
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5.
Changing Demographics
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New North Carolinians, coming from other
countries, add much to the cultural diversity of the state. This growing
diversity of North Carolina brings new challenges to public health
and the entire healthcare system. Healthcare and public health will
need to address the health and safety issues of these new residents.
Providing culturally appropriate preventive healthcare is an immediate
responsibility that will grow over the decade.
North Carolina is a popular retirement
state. The growing aging population is another challenge to North
Carolina’s public health and healthcare systems. As the Baby
Boomers begin to retire at the end of this decade, public health,
the healthcare system, and community services will need to expand
their capacity to respond to the growing needs of an aging population.
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6.
Infectious Diseases
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At the end of the 20th Century, new
infectious agents and diseases were being detected, for example equine
encephalitis, West Nile Virus, erlichious and Hepatitis C. Increased
international travel and trade, migration, importation of foods and
agricultural practices as well as bio-terrorism put infectious diseases
in a global context. Additionally, inappropriate use of antibiotics
and environmental changes multiply the potential for worldwide epidemics
of all types of infectious diseases. Other challenges are hospital-acquired
infections caused by antimicrobial-resistant pathogens. This problem
is caused by excessive or inappropriate use of antimicrobials and
has the potential to threaten communities and the public at large
because they are often untreatable. |
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