By Martha Smee MPH (c) MMS (c) and Dr. Heather F. McClintock PhD MSPH MSW
In the 21st century, the occurrence of pandemics has been increasing in frequency. A variety of factors explain this phenomenon, including increased travel and urbanization, a depleted health workforce, and climate change causing increased human-animal contact. Zoonotic diseases, which result from the passage of germs from animals to humans, account for 75% of emerging infectious diseases. The 2009 Swine Flu is just one earlier example of the impact of zoonotic disease. Other pandemics from the past two decades include the SARS-CoV-1 pandemic of the early 2000s and the SARS-CoV-2 pandemic which began in late 2019. SARS-CoV-2, which may be better known as COVID-19, is the most widespread and deadly pandemic in recent history. Most people are probably sick of hearing, “We’re living in unprecedented times!” But it’s true. No other event has so clearly exposed the vulnerabilities of our modern world. No other event has touched billions of lives, rattled economies worldwide, and changed the way that we think and feel. In the lens of public health, it is worthwhile to take a look at how COVID-19 impacted the healthcare systems landscape, and what role universal health coverage (UHC) could play in our preparation for future pandemics and our “new normal” in the context of COVID-19. COVID-19 may have been “unprecedented,” but when (not if) the next pandemic occurs we must not let history repeat itself.
Health systems across the world felt the impact of COVID-19. The World Health Organization (WHO) reports that 92% of countries reported disruptions in essential services. Included are 25 million children who were deprived of routine immunization. Diversion of supplies and manpower to COVID-related illness left few resources to administer essential services, treat routine illnesses, and respond to emergencies. Not all countries were equally affected. High-income countries reported less service disruptions compared to low-income countries. In addition, countries with greater UHC were less impacted. When controlling for covariates, one study found that countries with high UHC experienced significantly less decline in childhood immunization coverage compared to countries with low UHC. These results show the potential of UHC to act as a protective factor against external shocks to a health system, such as a pandemic. Further, economic inequality plays a role in the resiliency against COVID-19. One study showed that poor and more vulnerable populations had a harder time bouncing back, finding that the richest and poorest quintiles globally lost about the same amount of income in 2020, but only the richest quintile recovered the majority of their losses in 2021. Inequalities exacerbate the impacts of COVID-19 worldwide.
As great as it would be, UHC is not a cure-all. A better future can be built through coordination of various policies and efforts to promote population health and equity. UHC is one key component, but on top of it we need policies which invest in social services, promote climate resiliency, and increase global health security. All of these pieces work together. Investing in social services such as paid sick leave, supplemental nutrition programs, and affordable housing contributes to tackling the social determinants of health and root causes of inequity. Climate policy can address the threat that climate change is posing to our existing systems. Global health security programs and initiatives can promote the proactive response to acute threats to public health. All of these components complement one another and work in harmony to create the foundation to best promote health and well-being.
Martha Smee MPH (c) MMS (c)
Martha Smee is a current student in Arcadia University’s Dual Master of Public Health/Master of Medical Science in Physician Assistant Program. As an MPH student, her capstone research explored the relationship between state Medicaid policy and mental health outcomes. She completed an internship at the Free Library of Philadelphia’s Culinary Literacy Center where she assisted with curriculum development and program facilitation to promote literacy through food, cooking, and community-building. Her public health interests include health policy, access to mental health services, and environmental health. After graduating, she plans to continue practicing evidence-based public health as a primary care provider in the Philadelphia area.
Dr. Heather F. McClintock PhD MSPH MSW
Dr. McClintock is an IH Section Member and Associate Professor in the Department of Public Health, College of Health Sciences at Arcadia University. She earned her Master of Science in Public Health from the Department of Global Health and Population at the Harvard School of Public Health. Dr. McClintock received her PhD in Epidemiology from the University of Pennsylvania with a focus on health behavior and promotion. Her research broadly focuses on the prevention, treatment, and management of chronic disease and disability globally. Recent research aims to understand and reduce the burden of intimate partner violence in Sub-Saharan Africa. Prior to completing her doctorate she served as a Program Officer at the United States Committee for Refugees and Immigrants and a Senior Project Manager in the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania. At the University of Pennsylvania she led several research initiatives that involved improving patient compliance and access to quality healthcare services including the Spectrum of Depression in Later Life Study and Integrating Management for Depression and Type 2 Diabetes Mellitus Study.
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