Healthy populations translate into productive and stable nations. Universal health care (UHC) is a pragmatic and ethical ideal that, thanks to social and economic progress, seems almost achievable. However, UHC means different things in different contexts. The minimum ideal is that no individual or family should suffer financial hardship because of accessing good-quality medical assistance. Bloom et al. review health priorities around the world and what will be needed in terms of skills, funds, and technology to achieve health care access for all. The September 1978 Alma-Ata Declaration is a landmark event in the history of global health. The declaration raised awareness of "health for all" as a universal human right, whose fulfillment reduces human misery and suffering, advances equality, and safeguards human dignity. It also recognized economic and social development and international security as not only causes, but also consequences, of better health. In addition, it highlighted the power of primary health care and international cooperation to advance the protection and promotion of health in resource-constrained settings. Building on the achievement of Alma-Ata and gaining further traction from the Millenium Development Goals and the Sustainable Development Goals set by the United Nations, universal health care (UHC) has emerged in recent years as a central imperative of the World Health Organization (WHO), the United Nations and most of its member states, and much of civil society. UHC characterizes national health systems in which all individuals can access quality health services without individual or familial financial hardship.
The era of Public Health 3.0 is an exciting time of innovation and transformation. With the Public Health 3.0 framework, we envision a strong local public health infrastructure in all communities and its leaders serving as Chief Health Strategists that partner with stakeholders across a multitude of sectors on the ground to address the social determinants of health. With equity and social determinants of health as guiding principles, every person and every organization can take shared accountability to ensure the conditions in which everyone can be healthy regardless of race, ethnicity, gender identity, sexual orientation, geography, or income level. If successful, such transformation can form the foundation from which we build an equitable health-promoting system -- in which stable, safe, and thriving community is a norm rather than an aberration. The Public Health 3.0 initiative seeks to inspire transformative success stories such as those already witnessed in many pioneering communities across the country.
Two-time cancer survivor Elliot Munro was at risk of losing his foot after avascular necrosis caused his bones to die. The year was 1967, and Dr. Harold Freeman had just arrived at Harlem Hospital for his first job. He had learned the latest techniques during his surgery residency at Howard University and Memorial Sloan-Kettering (MSK). But now in Harlem, he was devastated to discover that most of his patients had disease that was too far advanced for surgical cure. His patients -- mostly poor, African American women with breast cancer -- had only a 39 percent survival rate, as compared to the usual 75 percent.
With the passage of the Chronic Care Act, Medicare Advantage plans have been scrambling to figure out how to offer supplemental benefits to their members. Passed as part of a Bipartisan Budget Act last year, the Chronic Care Act promotes the use of benefits that maintain health or keep a beneficiary's health from deteriorating, and the benefits don't have to be health-related. Instead, they can include help for social determinants of health that include housing, nutrition and transportation. Under the act, the supplements can also be tailored to the individual, when it comes to qualifications. The same benefits don't have to be offered to every beneficiary, he says.
Two new and seemingly unrelated approaches to delivering healthcare are starting to take shape in the industry: the use of artificial intelligence, and the integration of social determinants of health in crafting care plans. Both trends are developing independently, but they're likely due to intersect; factoring in SDOH is possible due to data, and if AI shines in any one particular area, it's making sense of complex data sets. If the social determinants are comprised of the socioeconomic factors that can influence a person's health -- income, education, access to transportation, etc. -- then AI has the potential to allow providers to make the best possible use of that information. That becomes increasingly important as value-based care emerges. With reimbursement increasingly tied to health outcomes, providers have a real incentive to ensure they're delivering the best care possible.