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2015 Top 10 Predictions in Public Health

Originated by: Tammy Pilisuk

Submitted: 06 Jan 2015

Last updated on: 6 Jan 2015

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Let’s face it. If you work in public health, you know we’re always fighting uphill battles and there’s never enough funding. Fending off challenges is what motivates many of us and keeps us nimble. And so, as I started looking towards the year ahead, I found myself pleasantly surprised. I won’t sugar-coat the looming threats. They are daunting. But I’m excited to think about upcoming innovations, scientific advances, new policies, and model programs ripe for replication. So, with a health-in-all-policies perspective, I lay out my predictions for 10 stand-out public health issues for 2015. Let’s roll up our sleeves. Happy New Year!

1. ACA Supreme Court Review

Ready or not, the Affordable Care Act (ACA) is once again heading to the Supreme Court. At stake is whether the law allows consumers purchasing insurance through the Federal portal to extend the same discounts that states provide. Eliminating the discount could gut the exchange’s value to federal consumers. In the meantime, it’s enrollment as usual for 2015. Share this this updated ACA enrollment guide from the IOM.

2. Defending Safety Net and Programs and Regulations

  • Medicare Private voucher program proposal. With a new GOP majority, I expect to revisit proposals to privatize Medicare. The American Public Health Association (APHA) is on record opposing such a policy move as undermining the foundation of Medicare’s guaranteed coverage. Brace yourselves for some ideological power-plays over health care access for seniors.
  • Access to Abortion Services. APHA supports Access to abortion and ensuring the availability of qualified practitioners. The access to safe and legal abortion services at the state level has narrowed rapidly across the majority of US states since 2013. Now, this sharply partisan issue is likely provoke both Congressional challenges and more states to seeking to restrict these services, especially for low-income women.
  • Environmental Protections. Expect attacks on environmental regulations and the Environmental Protection Agency (EPA). Republicans are candid that their goal is to end the EPA. Clean air standards and more may be threatened.

3. New Vaccines

  • Ebola Vaccine. Likely the most fast-tracked vaccine trials ever, I’m not the only one predicting that we’ll see an ebola vaccine in 2015. Together with infection control protocols established for the affected West African countries, this will hasten the end to what had seemed an intractable crisis—though we’re not likely to snuff out ebola completely within the year.
  • HPV Nonavalent Vaccine. Merck’s nine-valent HPV vaccine received FDA approval in 2014. It’s very likely that this will replace, or partially replace, their current quadrivalent (4-valent) version. The newer vaccine will increase the percentage of cancer-causing HPV types prevented from 70% to 90% and potentially prevent tens of thousands of cancers per year. It may only need 2 doses instead of the current 3. The Advisory Committee on Immunization Practices (ACIP) should make a recommendation in the first half of 2015 with rollout later in the year.

4. National Policy on Police Violence in Communities of Color

In 1966, the Black Panther Party emerged in Oakland CA with one of its main missions to have members patrol the streets and protect the Black community from police brutality. Tragically, in 2014 we haven’t come very far. But with the proposals offered up by the President, his new Task Force on 21st Century Policing, and new policy proposals in the City of Ferguson and New York, this is an issue of public safety whose time may have finally come. Let’s hope for a new direction.

5. Replicating the AIDS RAPID Program

San Francisco’s RAPID program was profiled in the Time Magazine in December as a new paradigm in immediately treating newly diagnosed people testing HIV positive. By catching the virus before it really damages the host’s immune system, an anti-viral drug protocol is started right away. I’m predicting this successful model will take root in other cities

6. Regulating E-Cigarettes

It’s not just steam! Health consequences of e-cigarettes including second-hand nicotine inhalation, have been found. There’s a good bit of evidence showing concern for e-cigarette use. So far, they are largely treated as a “safe” substitute to smoking. I predict this tide will turn soon. We should see more movement to regulate e-cigarettes, just as other tobacco products are regulated. A 2014 WHO-funded paper lays out regulatory recommendations and APHA also just took a support position on regulating e-cigarettes. SurroundHealth members shared their thoughts on the regulation of e-cigarettes—see what they had to say.

7. Protecting Vulnerable Children

Starting 2015, the National Children’s Center for Rural Agricultural Health and Safety (NCCRAHS) will be funding, via NIOSH, seven regional five-year outreach project to provide safe places for children while their parents are working. The California Migrant Clinician’s Network has already announced their award. Looks like a worthy project. I predict some positive results as the award sites ramp up.

8. Preventing Falls in Older Adults

New York State Department of Health’s presentation on fall prevention was a spotlight issue at the 2014 APHA convention. Falls are gaining recognition as a preventable injury we can do something about. I think we’ll see a growth of programs like New York, the University of Texas, Arlington and others.

9. Building Healthy Communities

This looks super exciting, BuildHealthyPlaces.org is launching a new initiative to help communities thrive based on principles of social determinants of health. Let’s give them some time to spread their wings during 2015 and beyond. Interested in this topic? Check out our SH article about building healthy communities.

10. Labeling Restaurant Calories

It would be great to say a National Food Policy or a new agenda for agriculture are coming in 2015. But they’re not. We do have a step in the right direction: new restaurant calorie-labeling regulations go into effect December 2015. This leaves most of the year for restaurants and groceries with prepared foods to get ready. I’m predicting fewer frappuccino and large fry sales by 2016. It could make a dent in the fight against obesity.

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