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How to Prevent Future Pandemics: Infrastructure

Hello and welcome to the second installment of my miniseries on how to prevent future pandemics! There are a lot of different aspects to preventing future pandemics, but I will focus on four main areas: vaccinations, infrastructure, public health infrastructure, and research. We’ll focus on one of these areas over the course of four different posts. This post will focus on infrastructure.

What do I mean by infrastructure? I mean the physical and organizational structures and facilities that allow our society to operate. This includes things like buildings, roads, power supplies, water treatment, sanitation, etc. Every country in the world needs to be able to invest in good infrastructure. Infrastructure allows us to progress as a society by prolonging life, making it cleaner, and making it more efficient. Infrastructure impacts public health directly. When infrastructure is not prioritized, it can and does impact public health. Some examples of public health impacts from poor infrastructure are:

  1. Cholera—The longest running pandemic in history is due to cholera1. According to the World Health Organization, “The best way to prevent cholera, and other water-borne diseases, is with the investment and maintenance of community-wide water, sanitation, and hygiene facilities.”4 Cholera is one example of many water-borne diseases that cause diarrhea and dehydration.
  2. Lead poisoning—The major causes of lead poisoning in the United States come from lead-based paint and lead contaminated dust in deteriorating buildings2. It can also be found in water, due to lead in pipes, as the crisis in Flint, Michigan demonstrates3. Lead poisoning can affect physical and mental development and can be fatal4. It can cause developmental delays, learning difficulties, seizures, hearing loss, abdominal pain, and more4.
  3. Asthma—Asthma is a common lung disease, especially in children. It is linked to exposure to poor indoor and outdoor air quality. Indoor air quality refers to being exposed to asthma triggers such as mold, rodents, cockroaches, and smoke. According to the U.S. Department of Housing and Urban Development, kids living in urban areas and crowded and/or unclean conditions are especially at risk5. It’s also more likely in people who are renters, and not homeowners. According to a report of the 2015 American Housing Survey, “Renters are particularly vulnerable. Rental housing inspections, federally mandated housing-quality inspections of assisted housing, smoke-free policies, and integrated pest management may reduce renters’ exposure to asthma triggers, particularly smoke, mold, and leaks. Renters may have fewer means to address these issues on their own because of leave restrictions or building-wide problems, so action by the U.S. Department of Housing and Urban Development, private landlord education, and legal aid for tenants may be required.”6

The federal government of the United States has identified several different areas to focus prevention efforts around, and this is best demonstrated in Healthy People. “Healthy People 2020 is the federal government’s prevention agenda for building a healthier nation. It is a statement of national health objectives designed to identify the most significant preventable threats to health and to establish national goals to reduce these threats.”7 I’ve focused on clean water and buildings as examples of how infrastructure is important to public health, though they are not the only examples. The Healthy People 2020 initiative focuses on six themes in environmental health (this is the umbrella under which infrastructure falls), the first four of which directly relate to infrastructure: outdoor air quality, surface and ground water, toxic substances and hazardous wastes, and homes and communities8. Infrastructure is vast and wide, much like its impact on public health. The longest running pandemic in human history is one that is best addressed not by a vaccine or pill, but by investing in and improving infrastructure throughout the world.

What you can do:

  • Get tested. This applies to asthma and lead-poisoning. Understanding your allergies and those of the people around you, including children, helps you to understand potential asthma triggers. Talk to your doctor about allergy testing. Additionally, if you suspect lead poisoning, talk to your doctor about testing.
  • Clean. Make sure that your home is free of dust, mold, smoke, water leaks, and other potential allergens that act as triggers for asthma. This may require that you work with your landlord and/or others in order to make your house safer for you and your family.
  • Vote. Many infrastructure projects are decided upon and developed at the state and local levels.

 

References

  1. The World Health Organization. Cholera: The Forgotten Pandemic.–https://www.who.int/cholera/the-forgotten-pandemic/en/
  2. The Centers for Disease Control and Prevention. Childhood Lead Poisoning. https://www.cdc.gov/nceh/lead/factsheets/lead_fact_sheet.pdf
  3. Natural Resources Defense Council. https://www.nrdc.org/stories/flint-water-crisis-everything-you-need-know
  4. Mayo Clinic. Patient Care & Health Information. Diseases & Conditions: Lead Poisoning. https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717
  5. United States Department of Housing and Urban Development. About Asthma. https://www.hud.gov/program_offices/healthy_homes/healthyhomes/asthma
  6. The Urban Institute. The Relationships between Housing and Asthma among School-Age Children. Analysis of the 2015 American Housing Survey. 2017. https://www.urban.org/sites/default/files/publication/93881/the-relationshi-between-housing-and-asthma_0.pdf
  7. Centers for Disease Control and Prevention. Division for Heart Disease and Stroke Prevention. Healthy People 2020. https://www.cdc.gov/dhdsp/hp2020.htm
  8. Health People. 2020 Topics & Objectives-Environmental Health. https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-health