Among the many effects of COVID-19 on healthcare in the U.S., one of the most prominent is a renewed interest in complex areas of medicine that extend beyond the doctor-patient relationship, including public health services and the social determinants of health.
Current public health infrastructure is inadequately equipped for contact tracing and vaccine deployment in many regions, and the pandemic has exacerbated inequities in food and housing insecurity, both of which are linked to adverse health outcomes. Since COVID-19 is unlikely to evaporate by the end of 2020, it’s likely that the issues encouraging a broader social approach to healthcare will continue to affect investment in that sector in the year to come.
How Healthcare Changed in 2020
Nonpharmaceutical interventions to enforce distancing efforts and slow the spread of COVID-19 brought typical economic and social activity to a halt in spring. Although restrictions on movement have abated to some extent in every state, patients have continued to embrace telemedicine for routine visits and mental health, and many are forgoing in-office visits for the foreseeable future, particularly as advisory bodies like the WHO recommend against visiting the dentist except in case of emergencies.
Public health departments have struggled to secure funding for testing and tracing capabilities, which has brought new attention to the chronic underfunding of public health infrastructure. Officials are also concerned about the challenges of providing resources to at-risk children in areas where schools are closed, as they are a key component in the ability to provide meals, behavioral intervention, and social support to at-risk children.
What To Expect in 2021
Ongoing community spread of COVID-19 will likely potentiate many current top-of-mind issues. In particular, as job losses mount and schools close due to new infection clusters, practitioners and policymakers will find that many patient issues are related to the social determinants of health, particularly:
- Hunger and malnutrition in children and adults
- Social isolation and unsafe home environments
- Affordability of electricity and climate control
Coordination between community healthcare providers and public health officials will inform a successful approach to healthcare in 2021.
Considerations for Mental and Emotional Health
Policymakers have raised concerns about the mental health implications of closing schools and restricting economic activities, which accentuate the anxieties the general population might be expected to feel during a pandemic event. A recent study from the Centers for Disease Control indicates that social disruption and the fear of disease have had a strong effect on the nation’s mental health; just over 10% of respondents had seriously considered suicide in the last 30 days. For those deemed essential workers, the rate was twice as high.
The CDC recommends that communities focus on public health interventions to handle increased rates of mental health conditions, especially among vulnerable populations. Successful outcomes for these programs will be influenced by the degree to which they can provide resources to alleviate the material concerns patients face, such as drastically reduced income or losing access to childcare, which can affect both mental and physical health.
While COVID-19 is presenting an unprecedented set of challenges to healthcare workers and the industry itself, the necessary response may generate constructive effects in previously neglected areas of healthcare focused on social interventions and public health, which will create durable positive outcomes for patients.