Saturday, August 30, 2008

Public vs Individual Health

The difference between public and individual health that often stands in the way of disease eradication and incidence decrease is simple: public health aims to do what is best for the greater good, the population as a whole; individuals aim to do what is best for them and their survival.

These two things often do not coincide. Some vaccination programs, such as smallpox, can lead to a large number of illnesses or death, but eradicates the disease in the long-run. This is good for the population, but not for the individuals who face the risk of side effects when getting the injection. There are efforts to eradicate yellow fever and polio in Africa, but villagers will not take the vaccine for fear of what it might do to their children. This is a prime example of individual health decisions not coinciding with public health goals. The increase in Measles and the reappearance of Whooping Cough in the United States has also occurred because individual health decisions to not vaccinate children do no coincide with the public health effort to keep the diseases at bay. In this scenario, no one is wrong. We each do what we believe to be best for us and ours, and the public health system continues to do what it believes is best for the population.

So how do we solve this problem?
Individuals need to keep in mind the potential effect their decision has on the public health structure and be sure they are bypassing the recommendations to avoid serious consequences only. I won't go into my recommendations of what to avoid here, but the major childhood vaccines should be sought out for healthy children, any worried parents can ask to be sure a doctor is available if side effects occur - DPT (diphtheria, pertussis/whooping cough, tetanus), MMR (measles mumps rubella), and polio. There are no longer mercury-based preservatives in pediatric vaccines. The only one containing a preservative, though it is prior to purification and so considered preservative-free at the end, is the influenza vaccine. So any questions about serious side effects have been addressed. Again, this is an individual decision and information regarding side effects is available from your pediatrician. Ask questions that pertain specifically to your child's health if you are worried. Ask them how often they see severe side effects, that will give you an indication of the actual occurrence and not just statistics printed on paper. (Vaccines are just one example of what is covered by the health system.)

The public health system needs to keep in mind that they are the amalgamation of millions of individual health decisions and structure their guidelines to be, and recommend treatments that are, beneficial to the individual if they follow them. Yes, their goal is for the health of the population, but the population is made up of individuals, if their health increases their collective health increases. Noone wants medicine that has a 20% chance of killing them just because it will ensure 40% of the population is healthy in 20 years (just a made up example).

It is time that the public health and the individual health once again join hands to solve the current health problems, before it's too late.

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