America has undergone a transition in political power over the past year, one that has introduced uncertainty into the role the federal government will play at home and abroad. One of the more impactful roles that the government plays is in the provision of healthcare, including programs like Medicaid and Medicare that provide essential health services for the Nation’s most vulnerable. Highlighting the significance of healthcare in federal expenditures, the United States was once described to me as “a health insurance company with a military.” Considering national health expenditures represent around a quarter of the federal budget (military spending is around the same), this description, although hyperbolic, is apt.
This election was a referendum on the status quo, and the results suggest that, among other things, large swaths of the population are not pleased with the amount of federal resources and regulations governing healthcare. It remains to be seen what impact the new administration will have on the trajectory of healthcare policy in the United States, including but not limited to the Affordable Care Act. Regardless, one thing is certain: Finding ways to deliver healthcare (including prevention services) that are sustainable, scalable, and fiscally efficient will only become more important in the future.
Technology, be it the Internet, smartphones, or artificial intelligence, represents a promising tool with which to tackle the public health problems of today in an effective and efficient manner. At no other point in history have we had the ability to develop public health interventions and deliver them digitally into the pockets of millions, without having to dedicate substantial resources to implementation.
Particularly at this point in the epidemiological transition, the United States is primarily impacted by chronic, noncommunicable diseases that place a prolonged, costly burden on the healthcare system. Providing care digitally, without the allocation of undue human resources, is needed in the current public health landscape.
This issue of Continuum provides an exploration of technology and the ways in which it can address the various, complex public health issues facing society. The School of Public Health at Brown is shaping the ways in which technology is used in public health, and reflecting that focus inward, to train the next generation of public health professionals. The School remains focused on the innovative work being done by its faculty and the impact our students and alumni are having on communities in Providence and around the globe. This issue also recognizes the contributions of Terrie Fox Wetle, the inaugural Dean of the School of Public Health, who announced she will be stepping down from that role in the Fall of this year. Dean Wetle has made an immeasurable impact on the culture of the School of Public Health, from guiding us through the accreditation process last year to creating a supportive, collaborative environment where faculty and students can flourish.
As with every issue of Continuum, through these pages you will come to appreciate the meaningful work being done at Brown and the ways in which we are shaping the future of public health. Enjoy.