Public Health is a Public Good
The coronavirus pandemic has posed major challenges to population health and well-being, disrupting progress made in recent decades and exposing risks from underlying ill-health. The pandemic has also given the global community its biggest learning - that population health and economy are inseparable and the world is at great risk without a robust public health system.
Delivering the Fourth Distinguished Yusuf Hamied Lecture online, Dr. Linda Fried, Dean of the Columbia Mailman School of Public Health and Director of the Robert N. Butler Columbia Aging Center, underscored the need for investing in public health for our now longer lives and reframing public health as a vital public good in an increasingly globalized world. This lecture was organized by the Columbia Global Centers | Mumbai and the Columbia Mailman School of Public Health on April 28, 2022, and attended by a sizable international audience of academics and practitioners.
Dr. Fried’s presentation explored some of the critical 21st century threats to life expectancy across the globe, such as novel infectious agents, antimicrobial resistance, risk factors for non-communicable diseases, climate change, and food insecurity. The evidence of the last few decades has shown that poor health and disease prevalence is amplified by differences in the environments in which people live in and the resources they have access to. In countries like India where health and social disparities are high, despite the increased life expectancy of its population, there prevails a double disease burden from infectious and non-communicable diseases such as neonatal disorders, ischaemic heart disease, chronic obstructive pulmonary disease, diabetes, etc.
Offering a framework for understanding the necessity and value of investing in the health of populations, she pointed to lessons we can learn from examining the achievements of the last few decades. For instance, life expectancy at birth has substantially increased globally from 45 years in 1950 to 73 years in 2022, and in India, life expectancy has increased by 40 years since 1950. Advances such as these can serve as critical guides for developing resilient global health systems through a public goods approach.
Explaining her theory of public health being a public good, Dr. Fried explained the principles of public goods to be societal elements required by everyone, non-excludable and unrivalled in consumption, having no commercial incentive for production, and safe and cost effective when delivered at scale to the entire population. She argued that public health, when provided as an essential public good, has a high economic and social return on investment.
In her concluding remarks, Dr Fried remarked that without the support and effort of policy makers, governments and civil society, public health is unlikely to be provided as a public good. She said, “When we invest in preventing disease and promoting health across the life course, using what we know now and what we will learn in the coming years, we will have the opportunity to do the unthinkable, to add to the victory of children leading now longer lives, and healthy longevity for all.”