Pharmacists who work in community settings practice public health pharmacy on a daily basis, but probably just didn’t have a name for it.
What is public health?
Public health means “the health of the many versus the health of one”, that is, focusing on the health and well-being of the people rather than the individual patient. It differs from clinical medicine because of its emphasis on preventing communicable diseases rather than curing diseases.
One of the most successful examples of population health in modern medicine is the invention of routine vaccinations recommended for the prevention of communicable diseases. Before this modern miracle, thousands of children and adults died from vaccine-preventable diseases each year.
Pharmacists who work in community settings practice public health pharmacy on a daily basis, but probably just didn’t have a name for it. Prevent disease by educating patients on preventive screening, chronic disease prevention, harm reduction strategies, and vaccinations.
The different types of public health interventions include epidemiology and surveillance, health education, advocacy, policy development, screening and social marketing.
Ten Essentials of Public Health
- Monitor health status to identify and resolve community health needs.
- Diagnose and investigate health problems and health risks in the community.
- Inform and educate the community on public health issues.
- Mobilize community partners to identify and resolve health problems.
- Develop policies and plans that support individual and community health efforts.
- Enforce laws and regulations that protect health and ensure safety.
- Connect those in need with personal health services.
- Ensure a competent workforce in public and personal health care.
- Evaluate the effectiveness, accessibility and quality of personal and population-based health services.
- Search for new perspectives and innovative solutions to health problems.
The roles of traditional pharmacists in public health have been associated with the federal government as commissioned officer pharmacist to the United States public health services through the United States Department of Health and Human Services and other agencies. and Federal Programs, Indian Health Services, and the US Federal Government. Bureau of Prisons. There are also pharmacists who work directly for the Centers for Disease Control and Prevention as a public health researcher, FDA, and Drug Enforcement Agency.
With the expansion of the scope of pharmacy practice authorized by the United States Department of Health and Human Services (HHS) through the Public Readiness and Emergency Preparedness Act (PREP Act) for pharmacists, pharmacy technicians and interns in pharmacy, the need for outpatient care, community pharmacists, and outpatient pharmacists to become more involved in the provision of public health interventions have become even more priority.
The 9th Amendment to the HHS PREP Statement on Expanded Access to COVID-19 Therapies Adds Coverage to Include Professionals Trained to Administer Covered COVID-19 Therapies, Providing Pathway for Increased Access to COVID-19 Therapies , especially in sharply increasing states with increasing numbers of COVID-19. 19 cases and in rural areas where access to hospital and outpatient services may be more limited. This is in addition to previous changes that allowed pharmacists, qualified pharmacy trainees, and pharmacy technicians to administer pediatric vaccination (ages 3 and up) in all 50 states, as well as ordering / administering tests. and COVID-19 vaccinations.
The misinformation has been declared a “threat to public health” by US Surgeon General Vivek Murthy, MD, MBA. Sadly, too many lives have been lost during this pandemic due to misinformation, including anti-vaccine and anti-mask rhetoric. Pharmacists are in a unique position to help address this threat to public health as a pillar of the community that patients love, know and trust. This does not necessarily have to stop at the pharmacy counter and can be shared through advocacy and community outreach.
There are many examples of ways pharmacists can contribute to public health or the health of the population. These include vaccination services for adults and pediatrics; disaster preparedness (mass prophylaxis and vaccination); COVID-19 test and vaccination; HIV prevention (PEP and PrEP); hormonal contraceptive services, which include emergency contraceptives and medical abortion; maternal and child health through antenatal care and lactation / breastfeeding support services; risk reduction strategies (needle exchange and access to condoms, * which are covered by Medicaid); LGBTQ care (gender affirmation and hormone therapy); substance use disorder treatment services (education and naloxone distribution); management of viral hepatitis (screening and treatment for viral hepatitis C infection); and tuberculosis prevention (management of latent tuberculosis infection).
The COVID-19 pandemic has drawn renewed attention to public health practice and why getting it right is so important. This has led to a better understanding of existing disparities and inequalities in health. Public health works best when you don’t know it exists.
Public health advocates work behind the scenes to prevent the transmission of communicable diseases, advocating for safe streets, clean air and clean water. Pharmacists are one of the most trusted and accessible healthcare professionals. Most patients can access the COVID-19 vaccination / test within 5 miles of their home due to the efforts of pharmacies and pharmacists during this pandemic.
Public health is not only good medicine, it is also good for the community. Improving access to health care and preventive care services will improve health outcomes and reduce overall health care costs.
Health equity should be a priority for the underserved and most vulnerable of our population in order to address the health disparities that the pandemic has exacerbated. Most public health services are billable and reimbursable through Medicaid billing codes that have been updated to track the expansion of telehealth, telemedicine, and remote patient monitoring.
There are so many opportunities for the profession of pharmacist and for pharmacists to be able to practice at the peak of their license to practice while having a lasting and meaningful impact in their communities. Public health is important and must be a priority.