What public health needs is advocates

With more knowledge and advocates for the cause of prevention, public health systems have more time and energy to focus on those who really need care.

By Carla Decotelli-Mendes*

I come from a country where Public Health is synonymous with universal access, or at least it should be, according to our legislation. In practice, we know there are numerous difficulties in ensuring care for all people. For this very reason, we need to focus our energy on preventive health policies, much more than just treating diseases that are already established. It’s cheaper for the system, and it’s much, much more beneficial for people.

Here in the United States, where I have lived for three years, the health system is very different from the Brazilian one. However, it is no less important we reflect on how Public Health is evolving over here. In this sense, the recent study Building the US public-health workforce of the future, carried out by McKinsey & Company, brings us some clues.

Decrease of workforce

The survey points out that the number of workers in the US public health system has been decreasing, a phenomenon that began even before the Covid-19 pandemic took hold in the world. Between 2008 and 2019, such a decrease reached 16%. The scenario only worsened with the pandemic and the consequent losses of professionals due to resignation and, mainly, problems such as Burnout syndrome. After all, we have all been greatly affected by finding ourselves on the front lines of an unknown and highly contagious disease that has overwhelmed hospitals and changed the dynamics of society far beyond healthcare systems.

One of the ways pointed out by the study to retain this shortage of workforce was the announcement by the US government, in 2021, to invest 7.4 billion dollars in recruiting and training public health agents.

But that is not enough. Let me explain why.

Advocating for the cause

As the McKinsey study shows - and as I have always believed - we need to use some strategies beyond hiring and training people to work in Public Health. I draw attention to what I consider the most fundamental ones: cultivating advocates for the cause among the population.

Public and population health is done through example and education. The more people we have acting as advocates of prevention, the more we can bring more quality of life to the population as a whole.

Throughout my career, I worked with workers’ health programs in Brazilian companies and here at Johnson & Johnson. And I always see this individual as the focus of the actions I plan and carry out. This is because they are those taking the prevention and care message to their family and, thus, to their community as a whole. I believe this is a key factor in changing the disease-cure dynamics that still prevail today in healthcare systems worldwide.

When people become aware of their co-responsibility in taking care of their own health, we will change the game.

We Healthcare Professionals

As professionals working in the sector, our role is to expand this concept to as many people as possible. It is to bring quality health education to these people to become quality of life agents. Never let them depend on subterfuges, like Dr. Google or self-medication. Always encourage them to adopt healthy lifestyle habits and convince their families and communities that maintaining their well-being means being healthy. Not having the hospital doors always open for them when they feel sick.

With fewer people depending on care, we, as a system, can focus our efforts on those who, at some point, will need better clinical outcomes to restore such well-being. Our goal is always the quality of life and no longer curing a disease that has already established itself. By reversing this logic, naturally, the number of people with access to healthcare expands as healthcare becomes what it actually is. In theory, it seems obvious, but, in practice, this is not how it works (yet).

How about you? How do you see healthcare in the future? Let’s talk about it in the comments.

*Carla Decotelli-Mendes is a pediatric doctor, specialized in Public and Population Health, and the Global Public Health Strategy & Global Strategic Partnership Lead at Johnson & Johnson. She believes in the power of population and public health to bring quality of life and well-being to more and more people around the world.