Mission Possible: A Year in Review

As a long-time scientist and physician, I’ve treated patients in a range of environments – from U.S. cities and military bases, to sub-Saharan Africa and Haiti in the aftermath of the devastating earthquake in 2010. Throughout those experiences, I saw firsthand the impact that health disparities could have on health outcomes. That’s why – even when treating single patients – it was important to always consider the social determinants of that individual’s health.

The inequity in health that we see across the world today remains one of the greatest social injustices of our time. Access to healthcare and behaviors is greatly influenced by social factors and environment, including housing, transportation, and education. As the nation’s leading public health agency, CDC plays a crucial role in promoting the practice of health equity, and I’m committed to seeing that CDC puts science into action to confront the gaps in health and the social determinants behind those inequities.

2018 is a milestone for CDC – it marks the 30^th anniversary of the establishment of the agency’s Office of Minority Health – now called the Office of Minority Health & Health Equity (OMHHE). And while the name has changed over time, its mission remains the same: reducing health disparities. The theme that CDC’s Office of Minority Health and Health Equity developed in observation of its 30^th anniversary – “Mission: Possible” – resonates strongly with me. We must never underestimate the possible in public health. We CAN end health disparities and help ensure healthy lives for everyone.

Throughout the year, this blog series has highlighted the outstanding work that CDC’s national centers, institutes, and offices at CDC are doing to protect the health, safety, and security of all population groups. This includes:

• Addressing gaps in access and treatment for heart disease and stroke, particularly through control of high blood pressure and high cholesterol;
• Improving quality of care, while strengthening community partnerships to develop effective strategies to achieve equity in preterm birth;
• Using science and surveillance to inform strategies aimed at violence prevention, such as reducing structural inequities (e.g., strengthening household financial security) and promoting safe, stable, and nurturing environments (e.g., mentoring programs).

Despite progress, significant obstacles remain. Too many Americans experience different health outcomes depending on race, ethnicity, education, income level, and other factors – and these disparities are tied to unequal access to healthcare and education, discrimination, and stigma. As I’ve said repeatedly, stigma is the enemy of public health; there is no greater example of that than the opioid epidemic. This national crisis is a medical issue, not a moral failing, and it must be addressed as such.

Just last month, new CDC data revealed U.S. life expectancy has declined over the past few years. Much of this is driven by drug overdose deaths and suicides. Also, nearly 80,000 Americans died of influenza last flu season. Life expectancy provides a snapshot of the Nation’s overall health – and unfortunately, these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable.

We also know that, while the U.S. is among the wealthiest nations in the world, we can be far healthier. In order to address National Research Council and Institutes of Medicine Study findings, which revealed a large and rising “mortality gap” among adults age 50 and older, we must see the mission as possible.

The good news is we can reverse these troubling trends by addressing the social determinants of health and putting science into action when science has provided key solutions, such as the influenza vaccine. Social determinants are present early in life, so we have to lay the foundation for a healthy life early on and maintain a steady course through the aging process. We can promote preventive services such as annual flu shots, cancer screenings, and links to community services, as well as access to affordable and healthy food options, safe places for physical activity, and smoke-free spaces.

The biggest gains in life expectancy happened in the first half of the 20^th century, primarily due to bold public health initiatives. We need to continue to support public health to ensure that all people – regardless of age, education, gender, income, race, sexual orientation, or zip code – have the opportunity to attain the best health possible.

As my predecessors did, I understand the important role CDC plays in improving U.S. health equity. CDC remains the world’s best science-based, data-driven service organization focused on putting science into action to improve the human condition. The work conducted here underscores the importance of understanding – and creating strategies to reduce – the impact of stigma, discrimination, and inequity on the health of our Nation. We have the knowledge and science to identify health disparities and determine the appropriate interventions – and as CDC Director, I’m committed to continuing research into how social factors and environment impact health outcomes for people throughout life and operationalizing effective interventions.

As you know, change doesn’t happen overnight, but I’m optimistic about where we’re headed, and I’m confident that CDC will help to ensure that no possibilities are out of reach for the next generation.

Thank you all for being part of that mission.

Special thanks to Dr. Redfield for contributing this blog as part of the celebration of the 30^th anniversary commemoration of CDC’s Office of Minority Health and Health Equity. Our theme for the 30^th anniversary commemoration is Mission: Possible. We believe “healthy lives for everyone” is possible and a goal that resonates in public health.