April 5, 2020
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5 Greatest Public Health Concerns in U.S. Cities

For many who pursue a career in healthcare management, their paths will lead them to institutions in urban centers, which have unique public health concerns. You’ll often be tasked with managing a system that must cope with those unique challenges in novel ways. Hence, we’ve compiled a brief list of the most pressing public health issues you may confront in that context.

1. Poverty

To some extent, this factor touches many of the major problems that stress the healthcare facilities in the major urban centers across the United States. Populations that live in extreme to moderate poverty tend to have limited access to any adequate health care. In turn, this leads to preventable diseases spreading as they would not in more affluent areas. Additionally, it raises the mortality rate for these diseases as well as conditions associated with poor nutrition and unmonitored pregnancies. Individuals who live in these circumstances are also often less well-informed about sexually transmitted infections and their treatments, have limited access to primary nutrients and live in more densely populated housing conditions.

2. Contamination of Water Sources

While this is a broader issue that incorporates considerations of urban infrastructure, climate change, and enforcement of laws designed to reduce illegal dumping, individuals who manage or work within the health care system will face it directly. The damage of lead piping and water mains is far from isolated. It’s estimated that more than 5,300 municipal water systems in the United States still use lead pipes. No amount of lead in the human bloodstream is safe. Add to these airborne pollutants, direct contamination of water sources via illegal dumping or landfill leaching, and America’s urban public may face a significant suite of health issues in the future. This includes brain damage in both adults and children, developmental delays or shortfalls in children, cancer of every variety, but especially of the gastrointestinal tract, and other debilitating diseases.

3. Anti-Vaxxers, Communicable Disease, and Education

Individuals who work with the public to provide both effective health care and education about public health concerns deal with the complications of urban communicable disease spread. In any situation in which many people live in close quarters, conditions are apt to spread. Those with animal vectors, such as Zika, West Nile or Lyme disease, were once constrained by geography and climate. This is changing, and vector species are expanding into new territory. Other bacterial or viral infections once thought all but eradicated are gaining footholds in urban environments once more. The resistance to vaccination by some poses a threat to all, especially very young children. Coupled with this movement is an increasing resistance of bacteria to antibiotics, fed by years of excessive prescription and the public habit of not finishing their antibiotics courses.

4. Alcoholism and Related Health Complications

One might think of the consequences of excessive alcohol consumption in the immediate sense, but there are other far-reaching concerns. The CDC reports that binge drinking is associated with liver disease, increased potential for injury, and many other systemic diseases and cancers. But it also presents an indirect health crisis for cities beyond the years of life lost or the cost of repairs and health care to the drinker. It can also increase the potential for violent crime and domestic abuse. These factors directly impact healthcare professionals working with urban populations.

5. Inadequate Nutrition, Obesity, and Food Deserts

The final complex issue facing managers of urban health systems in the US is one of mounting concern. Food deserts are a phenomenon unique to this country, the only developed nation to contain them. Populations must travel several miles to obtain fresh food, often to their detriment regarding time and cost. What replaces grocery stores or markets compounds the health issues this presents—food vendors that peddle nutritionally void substances laden in fat, salt, and sugar. Obesity is a symptom with symptoms of its own and its presence in underserved, impoverished urban communities has grown and spread beyond demographic boundaries. Add to this type-2 diabetes, neurological and psychological complications, and a host of diseases reliant upon context, and you can see the problem quite clearly.

The close context of urban environments often compounds the complications medical professionals face. Managing systems that provide care for populations in American cities is a complex undertaking that must account for the underserved as well as those with ample access to health services and assess the needs of distinct communities. As a part of that, the greatest urban health care concerns must be taken into account when designing or implementing the systems through which care is administered.