It’s time for Pa. to invest in public health by fighting Hep A | Simon F. Haeder

August 14, 2019 6:30 am

By Simon F. Haeder

In case you missed it among the ubiquitous doom and gloom that dominated the news over the past few weeks, the nation is in the middle of a massive outbreak of hepatitis A, a highly communicable virus affecting the liver.

Nationwide, almost 24,000 individuals have been infected, 14,000 have been hospitalized, and 233 have died. In Pennsylvania, the CDC indicates just over 300 cases, with 204 hospitalizations and 6 deaths. The nation’s worst outbreak has taken place in Kentucky, which has also received the most notoriety because of the state’s particularly poor response leading to 59 deaths and close to 5,000 infections.

As a professor of public policy, let me put this is in perspective for you. In policy analysis, when estimating the costs and benefits of policy alternatives, it is now common to use about $10 million per statistical life.

This means the costs of the combined six deaths in Pennsylvania alone amount to societal losses of $60 million. Nationwide, we have lost a staggering $2.33 billion during this outbreak. And this does not account for the costs of sickness and hospitalizations.

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There is much to be upset about here. Hepatitis A is fully preventable. For comparative purposes, the Centers for Disease Control currently list the price of a dose of the hepatitis A vaccine as $17.61. Moreover, we have had ample time to see this coming as the epidemic has ravaged on since 2016.

More importantly, the recent hepatitis A outbreak serves as a harbinger about what lies ahead if we don’t act. Newspapers are full with stories about the increasing spread of countless dangerous diseases like syphilis (31,000 cases), gonorrhea (560,000 cases), chlamydia (1,700,000 cases), drug overdoses (70,000 cases), mumps (1,800 cases), measles (1,100 cases), and whooping cough (19,000 cases).

What all of these diseases have in common is that they are true public health crises. Medical care plays an important role in prevention and treatment, but it alone will not solve them. That is, these crises require a comprehensive and sustained public health response.

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We need to invest in local and state public health departments. We need to invest into frontline workers who go out into the communities most affected by these outbreaks and connect individuals not only to medical care but also to social services. We need to invest into our communities. And we need to do so now.

Unfortunately, investing in public health has not been a high priority for Pennsylvania policymakers. A recent report pegged us at 45th nationwide with a dismal $13 per capita for a total of roughly $186 million. In comparison, Kentucky spends almost three times as much per capita on public health services. Leading the pack are Washington, DC with $139, Alaska with $114, and Hawaii with $112. We ought to do better!

However, policymakers will remain hesitant to invest in public health. There are no buildings to be named, and no quick victories to be had. Moreover, many of the afflicted are often considered “undesirables,” individuals who are drug addicts, homosexual men, or the homeless.

Yet, if altruism is not enough, we should remind policymakers that outbreaks like these also pose tremendous challenges for local health care systems and communities, and create remarkable societal costs. And often, diseases may eventually spread to individuals who do not fall into the “undesirables” category. Think about that the next time you order food in a restaurant. Self-interest serves as a powerful incentive.

We all deserve better from our governments. Our health and well-being depends on it. And we should make sure to hold policymakers accountable.

Simon F. Haeder is an Assistant Professor of Public Policy at Penn State University’s School of Public Policy. He is also a Fellow in the Interdisciplinary Research Leaders Program, a national leadership development program supported by the Robert Wood Johnson Foundation. His work appears frequently on the Capital-Star’s Commentary Page. 

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