From Alzheimer’s disease to Zika virus, several public health issues have stood out in importance during 2016. Organizations like the Centers for Disease Control and Prevention (CDC), local public health departments, healthcare professionals, and non-governmental organizations are actively working on initiatives to address these complex problems.

The following are six important public health issues from 2016.

Top Public Health Issues of 2016

Alzheimer’s Disease

The most common form of dementia, Alzheimer’s disease affects 5.4 million Americans, a number that is projected to nearly triple to 13.8 million by 2050, according to the Alzheimer’s Association. One in three senior citizens dies with Alzheimer’s disease or another form of dementia, and the disease is the sixth most common cause of death in the United States.

People with Alzheimer’s disease often experience memory loss first, and, as the disease progresses, they have trouble with cognition, conversation, and responding to their environment. Those with Alzheimer’s disease live an average of eight years after the symptoms present.

There is no known cure for Alzheimer’s, but organizations continue to research the disease to better understand it. The CDC’s Healthy Brain Initiative studies public health data, conducts research, and educates Americans about various forms of cognitive impairment; Healthy People 2020 includes objectives for dementia.

Antibiotic Resistance

Bacteria evolve and mutate over time, developing resistance to the antibiotics used to treat them. The misuse or overuse of antibiotics has caused antibiotic resistance in bacteria to increase worldwide according to the World Health Organization (WHO). This is concerning for a number of reasons.

First, resistant strains of bacteria are harder to treat than non-resistant strains, taxing hospital and healthcare resources. In addition, many strains of bacteria that have developed resistance to antibiotics can be life-threatening if left unchecked. “Klebsiella pneumoniae is a major cause of hospital-acquired infections,” and methicillin-resistant Staphylococcus aureus (MRSA) kills an estimated 64 percent more people than non-resistant strains, according to the WHO.

To combat antibiotic resistance, the CDC focuses on measures to prevent infections and conducts surveillance. In addition, antibiotics are a limited resource; to combat overprescription or misuse of antibiotics, many hospitals and doctors are engaging in antibiotic stewardship programs—commitments to ensure the safe and responsible use of these medications.

Childhood Obesity

Although the prevalence of obesity among young children ages 2 to 5 has decreased significantly (from 13.9 percent to 9.4 percent since 2003, according to the CDC), childhood obesity affects 17 percent of the child population overall. In addition, “Obesity disproportionally affects children from low-income families,” the CDC says. There are a number of reasons this is the case, including lack of full-service grocery stores in low-income areas, lack of vehicle access, and the simple fact that healthy food is much more expensive than foods that typically contribute to obesity.

Childhood obesity can have many adverse health effects, such as increased cardiovascular disease risk, prediabetes, bone and joint problems, and the likelihood of becoming an obese adult. In adulthood, obesity can increase the risk of many different forms of cancer.

Although a healthy diet and lifestyle are the most effective ways to combat both childhood and adult obesity, socio-economic factors can make such diets and lifestyles difficult. In addition, children and adolescents are affected by many different factors, including advertising, the availability of healthy options at their schools, and the kinds of foods their parents provide to them. Prevention, education on healthy eating and active living, and nutrition policies for schools are effective ways to combat childhood obesity.

Prescription Drug Overdose

According to a report by the Surgeon General, 12.5 million people over the age of 12 misused prescription painkillers during 2015, and 2 million of those cases met the criteria for a substance use disorder. The number of prescription drug overdose deaths in the United States has quadrupled since 1999. “In terms of abuse and mortality, opioids account for the greatest proportion of the prescription drug abuse problem,” says the National Institute of Health (NIH). “Deaths related to prescription opioids began rising in the early part of the 21st century. By 2002, death certificates listed opioid analgesic poisoning as a cause of death more commonly than heroin or cocaine.”

Prescription drugs like Vicodin are often prescribed for pain, making them easier to obtain than drugs like heroin. However, even when these drugs are prescribed for medical reasons, prolonged use can cause addiction, and intensely unpleasant withdrawal symptoms can manifest when use of the medications is discontinued.

In 2014, the CDC added opioid overdose to its list of the top five public health challenges. The CDC runs a program called Prevention for States, which provides states with funding for use in prescription drug abuse tracking, prevention, and rapid response to crises. The CDC has also released official guidelines on prescribing opioids for chronic pain, and states have started adopting legislation to combat overprescription. The National Institute on Drug Abuse is also researching next generation analgesics, integrating drug treatment programs in healthcare settings, and focusing on education and outreach.

Smoking

According to the CDC, cigarette smoking kills more than 480,000 Americans each year. Smoking increases the risk of heart disease, stroke, multiple forms of cancer, asthma and other respiratory diseases, birth defects, gum disease and tooth loss, cataracts, arthritis, and more. In fact, cigarette smoking causes more deaths per year than HIV, illegal drug use, alcohol use, motor vehicle injuries, and firearm-related incidents combined.

To fight smoking, the CDC focuses on education. A recent ad campaign “Tips From Former Smokers” features interviews with former smokers who have developed cigarette-related health problems, in an effort to help smokers learn about the harmful consequences they may face.

The good news is that anti-smoking efforts are working, with adult smoking rates declining. In fact, smoking is at an all-time low in America, with only 15 percent of adults identifying as smokers.

Zika Virus

Transmitted primarily through the bite of an infected mosquito, Zika virus causes fever, rash, joint and muscle pain, and other mild symptoms in most infected people. However, a Zika infection during pregnancy can cause microcephaly in the fetus, a condition where the head is much smaller than expected. This birth defect can cause problems in brain development, seizures, hearing and vision loss, and other lifelong issues.

Zika was first discovered in 1947 by scientists in the Zika forest in Uganda. By the early 1980s, it had spread to Indonesia, Pakistan, other parts of Africa, and the Pacific Islands. The virus was declared a Public Health Emergency of International Concern by the WHO in February of 2016, after three major outbreaks and occurrences in 69 countries and regions of the world, including the United States. On November 18, 2016, the WHO lifted the emergency status of Zika virus, but declared that it is still a “significant enduring public health challenge requiring intense action.”

Wearing clothing that prevents mosquito bites or using insect repellant can prevent Zika infection. However, Zika can also be spread sexually and can be passed from mother to child. Though Zika is found primarily in Florida, many U.S. states have the type of mosquitoes that can be infected with Zika, so precautions in other states may become necessary, and people should take care when traveling abroad.

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