The “3” Series – Forging the Future of Health Care
3 Public and Health Policy Challenges That Will Define the Next Generation
Through forecasting future disease and mortality rates, demographers like Dartmouth Institute Assistant Professor Samir Soneji, PhD, are able to predict how changes in population affect public policy. In this installment of the 3-Series, he outlines 3 public and health policy challenges that will define the next generation.
Social Security—the proverbial third rail of American politics—will require changes that will affect us all. Social Security has lifted generations of elderly out of poverty. But this pay-as-you-go system is not financially viable for much longer, in part, because we’re living longer than anyone expected. Social Security reform is necessary, but this reform need not be dire. A modest combination of increases in payroll taxes, reductions in benefits, and increases in the age of retirement would sustain the most successful social insurance program well into the future.
The public health victories on tobacco use, which have occurred over the past 50 years, may be eroded by electronic cigarettes. Adolescent e-cigarette use increases the risk of subsequent cigarette smoking initiation, especially among kids otherwise at low risk of smoking. And tobacco companies are repeating their same successful marketing strategies from decades ago—advertise e-cigarettes on television and sell candy- and fruit-flavored e-cigarettes. Federal, state, and local regulations originally meant for traditional cigarettes must now adequately address electronic cigarettes in order to prevent any retrogression in tobacco use.
- We’re facing a time of demographic uncertainty. The 0.1 year drop in life expectancy that occurred last year may not seem like much (that drop is just over one month). But in context, the last time U.S. life expectancy fell was 25 years ago. We might think the 0.1 year drop in life expectancy was a fluke. Another possibility, which is gaining traction among demographers, is that stagnant or declining life expectancy may persist for a while. Public resources should shift towards—not away from—people with the least economic and social resources in order to improve population health.