Wade Trappe

doi:10.19080/JOJPH.2024.09.555756

Opinion Article

Navigating Future Public Health Risks and Reducing Crisis Impact

Wade Trappe*

Rutgers, The State University of New Jersey, New Jersey, USA.

Submission: June 08, 2024; Published: August 08, 2024

*Corresponding author: Wade Trappe, Rutgers, The State University of New Jersey, USA.

How to cite this article: Wade Trappe*. Navigating Future Public Health Risks and Reducing Crisis Impact. JOJ Pub Health. 2024; 9(2): 555756. DOI: 10.19080/JOJPH.2024.09.555756

Keywords: Artificial Intelligence; Machine Learning; Public Policy; Health Threat; Tackling Food Production; Public Health Community; Crisis Impact

Introduction

A glance at the news quickly provides more than enough evidence that the world is heading towards many impending crises-all at the same time. As a global community, we are experiencing a plethora of worrisome dilemmas, including the oncoming effects of global warming, the emergence of several epidemics (or pandemics), and the scarcity of food and water arising from the shifting climate and geopolitical conflicts. The list, unfortunately, is easily expanded by any one of us. And every addition reveals further impacts to the health and well-being of the global community. While each one of these calamities is, by itself, an immense challenge to tackle (requiring focused scientific efforts and the mobilization of experts to steer public policy), the fact that there are multiple calamities to tackle simultaneously only compounds the challenge. In this opinion editorial, I set out to support the goal that we work together as a global community to focus our efforts to control both the trajectory going into the oncoming tipping points, and to mitigate the harmful outcomes should society cross any of these critical tipping points.

But how can we accomplish this?

While the task is certainly daunting, I believe that all one must do is look to history to be motivated by examples of how societal challenges were met with human ingenuity and scientific advancements. It is thus interesting to note that, while we are speeding toward a crossroad of crises, we are also speeding towards a confluence of numerous technological innovations, including new discoveries in gene editing, proteomics, artificial intelligence and machine learning (AI/ML), and medical therapeutics ranging from vaccines to monoclonal antibodies. While most of these advancements are just beginning, we are already starting to witness their benefits. To understand how we can control the multiple dilemmas facing public health around the world, it is useful to explore the challenges we face and the new tools that we can harness to protect humanity. Let us start by exploring the modern landscape of public health challenges that we can anticipate facing in the next decade or two. A brief and admittedly incomplete list includes:

Climate Change

The World Health Organization has identified climate change as “the single biggest health threat facing humanity”. The world attempted to react to such threats in the Paris Agreement, which set a target of keeping the average global temperature increase to 1.5°C. A very direct consequence of global warming is that there has been an increase in the average number of days that people have been exposed to heatwaves, which has resulted in an increase in heat-related mortality incidents globally [1]. Heat also amplifies other heath conditions, like cardiovascular diseases, and therefore places increased pressure on the global health care system. Overall, climate change serves as a trigger domino for many of the other public health challenges that follow.

Population Expansion

The world’s population has increased significantly in the past 20 years, increasing approximately 25%, from roughly 6.4 billion people in 2004 to roughly 8 billion people in 2024. The increase in population is expected to follow the global trend towards urbanization as people move from less populous areas to cities in search of economic opportunities. The United Nations anticipates that, by 2050, 68% of the world’s population will be residing in urban environments. As a result, the increase in population density will directly place stress upon the world’s public health systems.

Disease Outbreaks

Closely tied to climate change and the growth of the global population is the anticipated increased occurrence of diseases. Extreme weather events, such as heatwaves and powerful storms, can lead to the spread of vector borne diseases, like Malaria, Lyme disease, the Zika Virus and the West Nile virus. Meanwhile, the encroachment of civilization into the world’s wild lands will lead to the emergence of zoonotic diseases and the increased crosslinking of viruses, as has been witnessed with coronaviruses and influenza.

Food Scarcity

The increase in the world’s population, coupled with the harmful effects of global warming, are creating new challenges in providing food for the global population. The availability of food and water is paramount to good health and serves as the cornerstone for tackling public health problems at the global level. The recent trends of warmer climates and droughts covering more of the world’s surface are resulting in decreases in staple crops, such as wheat and corn. The impact of such shortages is felt most sharply in underdeveloped regions, which rely heavily upon such crops for basic sustenance.

Aging Populations

Some regions of the world, such as North America and Europe, have experienced a decline in birth rates, and thus will experience an increase in their population’s average age. As a result, parts of the world will continue to experience an increase in noncommunicable diseases. Such diseases are characterized by conditions that develop and persist over long periods of time, are often associated with the accumulated harmful impacts of lifestyle choices or are related to the gradual decay of biological functions such as cellular regulation, the immune system and maintenance of muscular tissues.

Mental Health and Wellbeing

Across the world there has been a shift in society’s awareness of mental health issues. Just within the past decade, there has been a rapid increase the number of cases of reported and diagnosed of depression, anxiety and other mental health issues. This precipitous decline in mental wellbeing appears to be a phenomenon of an always-connected society, which paradoxically is making many feelings more isolated, unsupported and worried. Climate change will further worsen the conditions. Surrounding mental health and wellbeing as extreme weather, food scarcity and degradation in economic conditions will lead to increased stress upon individuals and communities [1].

Disease Resistance

An emerging trend that links many modern diseases is their ability to evade effective therapeutic treatment due to underlying disease adaptation and evolutionary escape. Whether dealing with bacteria, viruses, or even cancers, these diverse disease types all exhibit selective pressures in response to therapies, which ultimately leads to the emergence of resistant subpopulations. These cases all result in increased pressure on public health systems, such as decreased treatment effectiveness, increased healthcare costs, and quite often poor treatment outcomes. In fact, antibiotic resistance has been recognized by the World Health Organization as one of the main public health dangers facing the world.

Clearly there are many other concerns to worry about, but this list is enough to work with to start balancing the other side of the equation to ensure a brighter and healthier future. Many of the identified problems are arising because of changes in our global ecosystem, increases in the world’s population coupled with an aging population dynamic, and the effects of technological advancements upon society. To make headway in tackling these problems, we can attempt to gaze into the future to predict the types of scientific advancements and societal changes that are needed.

Clean energy and decarbonization

One of the primary challenges that we must address is to reduce the dangerous trend associated with global warming. This will require many technical advancements, including developing alternative energy sources that reduce the global reliance on carbon-based energy sources (i.e. fossil fuels), thereby reducing the production of greenhouse gases. Further, complementary technologies that focus on decarbonization can further reduce high levels of gases, such as methane, and lead to green manufacturing processes with zero or near-zero byproducts. Such solutions are fundamental to minimizing any increase in the average global temperature or, if we want to have an audacious goal, to reversing global warming.

Addressing Social Inequities

The 2021 Lancet Countdown report recognized the global climate crisis and the steady increase in temperatures as “disproportionately affecting people who are marginalized or under-resourced… amplifying health and social inequities.” [2] Tackling health equity for many emerging health disorders will necessitate understanding both how environmental changes are making health challenges more burdensome to address, as well as how global warming is disproportionately impacting underserved populations. This will necessitate collecting data at a global scale, a task that has yet to be done in a manner that is spatially thorough and longitudinally complete- especially in areas that are characterized by sparse infrastructure. Another challenge that must be addressed is ensuring equitable access to healthcare. Getting medicine to where it is needed requires extensive collaboration with a focus on ensuring global logistics, which may be difficult due to geopolitical and geographical factors, thereby necessitating significant advancements in international relations [2].

Understanding how Health is Connected to Environment

It is important to advance our medical understanding of how and what environmental factors cause certain geographic locations or socioeconomic conditions to have a higher prevalence of some diseases than others. For example, many neurodegenerative diseases, such as multiple sclerosis and Parkinson’s disease, are believed to have a risk component that is characterized by a complex interaction between genetic and environmental factors. Thus, it is important to understand both the individual and the environment in which they live when attempting to mitigate a patient’s disease. Building upon the case of neurodegenerative disorders, advancing our understanding of the connection that lifestyle behaviors, socioeconomic conditions, and age have on neuro-regenerative processes (e.g., sleep disorders and the degradation of the glymphatic system) can inform communitydriven projects to affect awareness and support lifestyle changes to help prevent and delay age-related neurodegenerative diseases.

Advancements in Life/Health Sciences

Life sciences are applied to solve many of society’s most challenging problems, ranging from health and medicine to agriculture and nutritional sciences to public health, kinesiology, and biotechnology. To tackle acute cases of global public health challenges, such as vector-borne diseases, we will need significant advancements in low-cost diagnostic technologies that can classify illnesses or pathogens. Advancements in biosensor technologies, likewise, can be helpful in identifying and tracking the underlying causes for non-communicable diseases that are affecting older demographics. New therapies, driven by increased understanding of the underlying biological sciences, will need to be developed to treat illnesses. As noted earlier, such therapies must be developed and deployed in a manner that is globally equitable and affordable.

Doubling Down on Data and Data Sciences

The long-term success of tackling public health challenges will rely on multi-faceted teams with expertise in data sciences, life sciences, medical sciences, and public health. These teams must be able to address important questions about the public’s health while also collaborating globally to collect and manage the large amounts of data that will be generated. Addressing many of the problems associated with global health will require that teams work across national boundaries to collect data with sufficient spatiotemporal granularity to understand health impacts well enough to activate local, regional and global responses. Having enough data, for example, to forecast the spread of vector-borne pathogens would require rapidly detecting early occurrences of a disease, monitoring its spatial progression in near-real time, and mobilizing containment and treatment responses to prevent potential epidemics.

Tackling Food Production and Compassionately Ensuring Food Equity

Any approach to tackling food scarcity should start with the challenge of increasing food production while mitigating environmental harm. Starting with food production occurring at farms, it will be necessary to adjust farming practices to become more sustainable, with the goal of being able to produce more food while requiring less irrigation and fewer chemicals. Increasing food security must be coupled with reducing harmful impacts on the environment, as might arise from fertilizer and pesticides. Intentional and expanded use of community composting, for example, can reduce the levels of methane from landfills, and support healthy soil and the sequestering of carbon, thus serving to reduce reliance on fertilizers. Likewise, genetic modification of plants can be leveraged to adapt existing crop strains to the evolving state of climate change while also striving to maximize the yield of produce.

Complementing the need to expand food production is the need to secure food distribution in the face of geographical and geopolitical factors. Recent conflicts have made it difficult for aid agencies to distribute food and health supplies. While the obstruction and theft of international aid deliveries are protected under the Geneva Conventions and the UN Security Resolutions, these frameworks for protecting humanitarian workers and supplies lack sufficient enforcement to achieve their goals. Thus, the international community needs to come together to collaborate on establishing newer measures carrying stronger guarantees for enforcement and ensuring that humanitarian goals are achieved without barrier.

Education and Public Policy

Science and medicine are only two of the tools in the toolbox and are often used in reaction to the emergence of a problem, whether in an individual patient or in the context of a community. Proactivity, in the form forward-looking protocols intended to prevent the degradation of local ecologies and that help support the community’s health, are cost-effective approaches to improving global health. The public health community should engage society and be involved in our day-to-day life through many public-facing activities, such as by providing informative activities that educate people of environmental health risks and inform people of the need to evolve existing public policies. Other activities that foster positive social interactions aimed at encouraging healthy activities, such as combining dance and kinesiology to support general well-being, can also serve to provide an individual with physical rehabilitation, or serve as an easy form of preventative measures for a diverse class of diseases, ranging from cardiovascular to neurological disorders to mental health.

The trick to success is not merely making scientific and technological advancements but translating them into solutions that will benefit the broader public. But as we approach the critical public health crossroads, I believe it will be necessary for the world’s governments to truly work together to tackle the common threat, and not each other. While we might not all agree on geopolitics and economic motivations behind the decisions being made by countries and companies, we can all agree that preventing suffering from poor public health is a noble ideal that we should strive for globally. Therefore, the time is right for the global community to initiate a global effort that will combine advancements in science with new levels of global collaboration. While we will need to advance our ecological factors leading to global warming and will need to develop new sciences and medical treatments, it is essential that we do not lose sight of the need to address equally important economic, psycho-social, and lifestyle factors that will increase the prevalence or severity of public health concerns. Further, we must ensure that the solutions the global community develops are equitable, fostering good for everyone and with equal access, and that the full diversity of racial and ethnic communities are provided access to public health solutions.

One should not read this and think that the future is bleak. While there are challenges ahead, and the above discussion has identified many hurdles that we need to address, the global community has already started tackling many of these problems. Personally, I believe the global community, whether we are talking the medical community, the public health community, the politicians, the scientists, the humanitarian agencies, or the readers of this journal have more than ample ingenuity to add their contribution to the discussion and thereby help us chart a path forward that avoids many future public health calamities. As noted several times in this opinion piece, it is important that we bridge the language gap between the “public health community” and the broader “public community”. Therefore, we must be proactive and engage in the regular practice of educating and informing our local communities of health-related information that can support individual choices and practices, with the goal of affecting communal wellbeing.

Finally, I would like to conclude this opinion piece by answering: what am I excited to see develop in the public health community? If I were to look into the crystal ball and make a prediction, I believe that we will have to develop the infrastructure needed to collect a wide variety of data types (such as weather, water and soil quality, soil information, medical diagnostics, logistical data associated with the shipping of goods and food, medical records, etc.), and make such data available in real-time to teams with very diverse backgrounds across the world. These teams will have to work together through formalized multi-national collaboration agreements aimed at monitoring and addressing the world’s public health challenges. It is only through multi-national collaboration involving experts with diverse training, utilizing the latest technologies like the Internet of Things and artificial intelligence, that we will be able to steer society away from future precipitous events, mitigate risks to the public, and ultimately towards a healthy future.

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