Health Science Agenda: A Public Health Perspective

An editorial in the November issue of the AJPH [November 2007, Vol 97, No. 11; AJPH, 1936-1938] states that "The United States spends $2 trillion per year on health care, 2 to 3 times per capita than that of other developed nations. Despite this staggering financial investment, our citizens have a lower life expectancy than those in many other countries, and it has been reported that patients receive only about half the evidence-based care that they should." Source documents suggest that the vast majority of NIH dollars will be steered toward technological interventions, especially pharmacogenetics. The NIH curiously ignores "P" for prevention. This is the continuing policy base pushed by Congress and by cause based advocates. Public Health has little voice in Congress, I believe this is because it has chosen the wrong causes and the wrong champions in the past.