2017 ASTHO President's Challenge: Public Health Approaches to Preventing Substance Misuse and Addiction

Public health approaches to preventing disease, disability, and death led to remarkable advances in life expectancy and quality of life during the 19th and 20th centuries. Control of infectious diseases through improved sanitation, vector control, immunization, contact tracing, isolation and quarantine, improved diagnostic testing, judicious use of antimicrobial drugs, and improved outbreak response infrastructure has been a major contributor to these improvements in health. However, public health faces numerous long-standing and emerging challenges in the 21st century. In addition to the ongoing threat of emerging infectious diseases, psychosocial issues that have not been addressed as part of traditional public health practice create barriers to further improvements in health. Many of the successful public health approaches to control infectious diseases are based on understanding the cyclic chain of transmission of pathogens among susceptible hosts—spread of infection is interrupted by intervening at critical points in the cycle. Vexing health problems such as interpersonal violence, self-harm, and mental illness are interrelated with one another and with social determinants of health such as poverty and low educational attainment. These issues are not adequately addressed using