Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.
This week I’m doing something uncomfortable and something I am not known for doing. I’m making predictions for the upcoming year. And while I may not have a crystal ball, I have been paying attention to all things public health and medicine. And I feel like I have a clear sense of what will be making the health headlines in 2024.
Today, I’m sharing the three public health topics that I think will make headlines during 2024.
NOTE: the only constant is change. Or maybe it is better said that we cannot be surprised by surprises. If I were writing this in January 2014, I would not have been able to predict the Ebola outbreak (or fear-bola) that consumed the headlines during the summer and fall; if it were January 2016, I would not have been able to predict Zika; January 2020 COVID-19; or January 2022 mpox. What is highlighted below is the predictable.
Spoiler — COVID did not make my top 3 list for 2024. The virus will still be around. And the disease will continue to make people sick (some severely). I’d venture to guess that the virus will NOT develop seasonal patterns in 2024, but there will be new variants and new vaccines. COVID is here to stay and 2024 will likely look like 2023. There will be increases and decreases in cases. Updated vaccines will be available in the fall. And the very young, the elderly, and those who have compromised immune systems will continue to be at the highest risk for severe disease and death.
The topics that I’ve included on my list of predictions for 2024 are those that are new/gaining traction and will impact our day-to-day lives the most in the new year, and the ones that I am paying attention to as we move into the new year.
Hoping this post helps to educate and empower you
to be healthy and create healthy communities.
#1 — Climate Change & Health
2023 was officially the hottest year on record and climate disasters were commonplace — including 1 drought, 2 floods, 19 severe storms, 1 tropical cyclone, 1 wildfire, and 1 winter storm in the United States. More than 480 people died as a result of these events and the losses cost more than $1 billion.
In June 2023 we saw the first cases of locally acquired malaria in the United States in 20 years. WHO Director-General Tedros Adhanom Ghebreyesus warns —
“Our warming planet is expanding the range of mosquitoes, which carry dangerous pathogens like dengue, chikungunya, Zika and yellow fever into places that have never dealt with them before.”
As the planet heats up, mosquito-borne diseases, as well as other diseases carried by ticks, rodents, snails, and other vectors, will expand their geographic reach.
Additionally, there will be more extreme weather events — think hurricanes, floods, or deadly tornados. And heat waves will become more frequent causing increased deaths. We will also see increased air pollution, more pollen in the air, increases in food- and water-borne diseases, increases in food insecurity, increased stress, and more wildfires.
Given that 2023 was the hottest year on record, we will be suffering the health consequences in 2024. Headlines highlighting the health consequences of climate change will be commonplace. I anticipate we will see more locally acquired malaria as well as an uptick in other mosquito-borne diseases. Lyme disease and other tick-borne diseases will also increase.
Climate change in a public health emergency.
We need to be working towards prevention; not merely surveillance of the problem.
Expect to hear a lot more about climate change and health in 2024.
#2 — US Presidential Elections
In addition to it being a leap year, an Olympic year, and a solar eclipse year — it is also a Presidential election year. The Iowa Caucuses are 11 days away; here in Pennsylvania, the primary election is not until April 23 (~two weeks before President Trump’s trial is scheduled to begin). It will be a busy, messy, and contentious election season.
And public health will be on the ballot.
According to a KKF Health Tracking Poll conducted in November 2023, voters want to hear about many different issues, including inflation and the rising costs of household expenses. AND they want to hear about health. Specifically, voters say it is “very important” for the 2024 Presidential candidates to talk about affordable healthcare, the future of Medicare & Medicaid, access to mental healthcare, gun violence prevention, the cost of prescription drugs, the opioid crisis, the future of the Affordable Care Act, climate change, and COVID-19.
REMEMBER — who you vote for will have an impact on your community’s health.
“Who you vote for will impact everything from your access to healthcare and the amount of money given to public health agencies to prepare for the next emergency.”
As we head into election season, I highly recommend checking out healthyvoting.org. This website provides specific (based on where you live/vote) guidance based on advice from leading public health experts. It is designed to help you determine who to vote for to create healthy communities for all.
Expect to hear a lot about the importance of voting and understanding the public health implications of each candidate’s platform here.
It is important to note —
The American Medical Association has declared VOTING to be a social determinant of health, one of many non-medical factors that affect the health and well-being of individuals and their communities. Additionally, gerrymandering limits access to healthcare and leads to worse health outcomes.
And did you know…???
Communities with high voter turnout have better community health. And that across history and research voting has been associated with healthier communities. Specifically, women’s suffrage decreased child mortality by 8-15%. And the Voting Rights Act reduced economic inequalities and increased health spending throughout the United States. There is also evidence that voting is associated with improved mental health and reduced rates of cancer.
#3 — Supreme Court Decisions
On December 13, 2023, the Supreme Court announced that it would review a lower court decision that would make the drug mifepristone less accessible. The hearing will likely happen this spring with a decision expected by June.
Mifepristone (when taken with another drug, misoprostol) is used in a medical abortion. Mifepristone is ALSO a safe and effective outpatient treatment for early pregnancy loss (aka miscarriage).1 “It also helps prepare the body to empty the uterus (following the loss of a fetus). It does this by softening the cervix and helping the lining of the uterus break down.”
I know when people see the word ABORTION emotions heat up.
But please keep reading…
By accepting to hear this case, the Supreme Court is setting up a “collision between the Food and Drug Administration's 23-year study and supervision” of a pharmaceutical that has been determined to be safe and effective. According to my go-to/favorite public health lawyer, Larry Gostin —
“In one fell swoop, SCOTUS will decide access to the most common abortion method and the functioning of the FDA… Reproductive freedom is at stake as well as the scientific judgement of health agencies.”
Regardless of where you stand on the abortion debate — please see that this upcoming Supreme Court decision is HUGE. Really freaking huge. It matters to everyone with a uterus. And if you cannot understand allowing those individuals to make their own choices about their uteruses, please think about the more than 1 million individuals who have a first-trimester miscarriage each year. If the Supreme Court decides that mifepristone should not be available, individuals who need the drug to get rid of a lost fetus will NOT have access to the drug that is currently recommended.
That is unacceptable.
But it doesn’t end there — if the Supreme Court determines that mifepristone is unsafe and should not be available, it will be tanking the policies and procedures used by the Food and Drug Administration to authorize all medicines, vaccines, and medical devices. The three-phase clinical trial process that has been the global gold standard will be in jeopardy — and who will be able to set the standards for what is safe and effective will be uncertain.
I will be following these hearings closely.
Here’s to a healthy & happy 2024. Cheers. 🥂
Questions about these or other stories/headlines as we start 2024?
Please share this with your friends & family —
Miscarriages are REALLY common. More than 1 million first-trimester miscarriages are reported each year. And The American College of Obstetricians & Gynecologists recommends mifepristone to individuals who are miscarrying.