The May issue of the American Journal of Public Health (AJPH) carries an excellent discussion on the origins of efforts to improve the health for people in the U.S., which stemmed in part from the popularity of the term “public health.”

For example, drug and insurance companies often advertise their products as a means of improving a person’s health. While true as far as it goes, prescription drugs should address an individual’s diagnosed disease and illness. But, that is not public health. Nor is access to a physician, hospital and ancillary medical and nursing professional. The same can be said of hospitals. While all of these – pharmaceuticals, health care professionals and hospitals – are necessary in providing health care they, neither alone nor in combination, do not and cannot – guarantee public health.

By definition, public health is the sum total of all social, economic and political events that impact on the health of a country: jobs, income, education, housing and peace – these are the major determinants of the public’s health.

I have included “peace” in my definition of public health because war results in tens of thousands of deaths and disabling injuries directly, and the dislocation of millions of people who are forced to alter their way of even staying alive in such a manner as to affect the lives of everyone. And there are the waves of immigration and emigration caused by the rampages of transnational corporation that result in massive changes in employment and unemployment.

Housing – adequate, affordable housing – is a major component of public health. The British magazine, The Economist, reports skyrocketing costs of housing in the United Kingdom. In Ireland, Dublin reports the highest increase in apartment rental costs throughout Europe. War is destroying housing stocks in those countries suffering.

But poor housing and homelessness are not someone else’s problem. Listen to Mary E. Northridge of the AJPH: “In New York City alone, about 29,400 homeless people, including 12,500 children, spend their nights in shelters or hot-plate hotel rooms. Discrimination in the location of housing for people of color, the poor and the disabled contributes to egregious disparities in the health among population groups.”

The picture would be even more damning if Northridge had included the tens of thousands of new immigrants from Mexico, Latin America, Southwest Asia and other parts of the world.

Poor housing conditions are directly associated with major health problems: respiratory infections, asthma, mental health, severe injuries and lead poisoning. Issues such as sanitary conditions, overcrowding and poor ventilation, once thought of as a distant problem, are once again on the front burner in the cities of industrialized countries, just as they continue to grow in developing countries.

“Broad societal support is needed to solve the current housing crisis … In the final analysis, while safe and affordable housing alone cannot ensure sound population health, it is undoubtedly a necessary condition,” Northridge’s editorial concludes.

The author can be reached at pww@pww.org

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