Abstract
The field of medicine is a diverse sector that draws expertise from multiple disciplines. The field is also geared towards achieving the fundamental objective of promoting, preserving and caring for human life. The chiropractic profession is an alternative and complementary field of medicine that strongly espouses the ability of the human body to heal itself. On the other hand, public health promotes overall health and well-being of a people. Thus, the importance and complementarity of the two disciplines cannot be overstated. Given this, the importance of public health knowledge in advancing the chiropractic profession is unquestionable. This is especially the case as the American populace deals with such issues as chronic pain, weight gain, sedentary lifestyles, arthritis, back and neck injuries as well as occupational injuries. Ultimately, and beyond any doubt, chiropractic is a better profession when public health knowledge is integrated into its practices.
The Importance of Public Health Knowledge In The Chiropractic Profession
In order to build a more holistic public health policy, there is a need to include and involve professionals from multiple fields of medicine. The chiropractic profession is no different. Knowledge of public health would greatly assist and improve the relationship between chiropractic practices and how people view them. According to Daniel D. Palmer, the originator, chiropractic profession refers to the science of healing without the use of drugs. The profession is itself an alternative medical practice that is meant to complement the work of more mainstream methods by manipulating the musculoskeletal system of the human body ( Haneline & Meeker , 2011; Haneline, 2007). There is an inherent belief that chiropractic is based on the assumption that the human body possesses the ability or intellect to heal itself once a conducive environment is created (Haneline, 2007). Despite criticism of this system, evidence suggests that chiropractic treatment techniques are capable of not only complementing but also assisting in the management of various types of pain, especially back pain through the use of well-honed professional techniques and procedures. According to the American Chiropractic Association (ACA), 31 million Americans suffer from lower back pain at any given time. This is a 50 billion dollar health problem annually, with back pain being the leading cause of disability in adults across the U.S. Given its scale, the problem is also seen as a vital driver of the growth and spread of opioid abuse which is currently ravaging the adult American population. Alternative sources of pain management have forced the medical fraternity to incorporate chiropractic profession into the public health policy framework. It is therefore imperative that chiropractors understand the importance of public health in the larger medical services construct as they work towards being part of the solution to America’s healthcare problem.
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Public Health and Chiropractic
Public health is described by the American Public Health Association (APHA) as a series of individuals, communities, activities, and programs working together to prevent disease, injury and premature death while fostering conditions in which everyone can be safe and healthy (Haneline & Meeker, 2011). Public health integrates a number of practices that help sustain a unified effort in promoting the overall health of the population. Policies are drafted based on the findings and data extrapolated from research studies. Such studies are carried out in order to inform and guide the process of drafting, revising and publishing policy. This is done with the aim of holistically informing the management of the health of all individuals irrespective of race, age, background, and creed. The goal of public health is to be as inclusive and extensive in coverage as possible. This is achieved by deploying various tools and methods to identify the population’s most significant health risks, formulate strategies to mitigate against these risks and evaluate the progress and effectiveness of the measures taken.
In the ideal situation, the goal of the public is to develop a policy that is preventative, and one that allows the population to lead lives that reduce the chances of getting sick. This can be achieved, for instance, by practicing healthy lifestyle practices such as proper nutrition and sufficient exercise. Public health also offers guidelines and informs medical practices so as to manage illnesses of every kind. Ultimately, the goal is to offer the best possible care to individuals already suffering from certain diseases and conditions. Overall, at the core of public health is the welfare of the population. This is especially important because the health and wellbeing of a population is a crucial determinant of a nation’s productivity. A healthy nation in many cases leads to a wealthy nation. There is a direct correlation between the health of a country and its ability to be productive, to create opportunities for its people, and to create wealth ( Tompa, 2002 ). Further, the health and wellbeing of a nation's people is a crucial marker of progress, quality of life and standard of living.
Public health draws from a number of medical disciplines and is underpinned by a certain set of values. For instance, public health is able to integrate the disciplines of epidemiology, biometry and biostatics, environmental health sciences, health care services, occupational/industrial medicine, population science and international health (Haneline & Meeker, 2011). This wealth of knowledge helps to create a multi-prong approach to identifying and solving health issues affecting specific communities and the broader public. All this is guided by certain principles that underpin public health practices. These include such values as intentionally identifying public health risks; educating the communities affected by those risks; enacting policies that support and promote community efforts; identifying possible solutions; and working hand in hand with the affected communities.
Another essential function of public health is the creation of links between health care services and the people who need this care. In this regard, it ensures that the services offered are of high quality and that accessibility does not hinder the restoration and promotion of good health. Public health policies also guide the enforcement of training standards for the personnel involved in offering care to the public. Due to its multi-disciplinary approach, public health integrates numerous structures that aid in its execution. This is aimed at making sure that as many people as possible are given the information and care that they need to promote their health and well-being. The organizations involved can be grouped into three and include quasi-governmental, governmental and non-governmental. Quasi-governmental organizations perform duties and roles that are given to them by the government (Haneline & Meeker, 2011). In this case, funding for their day-day running comes from private donations and tax dollars. Governmental organizations are given specific mandates to tackle specific roles and meet specific public health needs. These organizations exist across the tiers of the government in the federal, state and county/local level and are fully funded by the government revenue collected through taxes.
Non-governmental organizations exist voluntarily to meet specific needs identified in communities as far as health is concerned. In this case, a non-governmental organization can be created solely to help solve one particular problem. A good example is a family planning clinic that creates awareness on family planning and birth control methods. The same clinic may even go as far as offering its services and products at discounted rates. Non-governmental organizations are solely responsible for fundraising to meet their operating costs. Several members of the chiropractic profession especially those with dual accreditation have found advisory roles on the Department for Veteran’s affairs, the Department of Defense and even the Department of Health and Human Services. This has occurred as more and more practitioners of the chiropractic gain acceptance in more mainstream medical circles.
Public Health Impact of Chronic Pain and Musculoskeletal Conditions
Chronic pain such as back pain and musculoskeletal conditions are some of the most common reasons for visits to a physician in the U.S. According to the ACA, back pain treatment costs Americans approximately 50 billion dollars per year. Owing to the magnitude of this challenge, big pharmaceutical companies are devoting a significant amount of their research and development resources towards the increasingly profitable pain management industry. Subsequently, all kinds of strong painkillers are being developed in laboratories across the U.S, with each pill carrying the promise of making a patient’s life easier. The American population has never before been presented with many such options for managing pain. The flip side to this new age of drug-based pain management is that many patients are now struggling with opioid addiction with varying levels of severity.
There is a clear need to offer alternative ways of managing chronic pain. Chiropractic practitioners could help meet the need and provide alternatives to this growing problem by using tried and tested techniques to help manage pain, especially in severe cases. The number of patients suffering from chronic spine pain as a result of various risk factors is increasing. These risk factors include posture, sedentary lifestyles, arthritis, back and neck injuries as well as occupational injuries. Driven by these factors, the average cost of treating chronic spine pain per patient annually is estimated at 6, 000 dollars (Haneline & Meeker, 2011). Likewise, the burden on the American health care system for all joint and bone health issues by 2004 was estimated at 894 billion dollars, which is equivalent to 7.7% of America’s GDP (Haneline & Meeker, 2011). The need for alternative, less expensive methods of chronic back pain and other forms of chronic pain emanating from musculoskeletal issues is thus essential and urgent. The need for methods of identifying, treating and managing chronic pain from musculoskeletal issues that are not invasive, heavily drug-reliant and are more holistic is a public health issue of national importance. Consequently, the expertise of chiropractors is in high demand at the policy, treatment and care levels across many communities in the U.S today. Sound advice on the way forward as far as musculoskeletal condition management issues are concerned is paramount and chiropractic practitioners are at the forefront of offering this.
The Role of the Chiropractic
A chiropractic practitioner has an important role to play in the public health sphere. There are clear knowledge gaps that exist in the population about everyday problems and the potential dangers of risk factors such as posture, ergonomic design of daily use products such as mattresses, chairs and other furniture, as well as the risk of wearing ill-fitting shoes and other forms of clothing. A good place to begin would be educating the public on the scale of the issues being experienced in the U.S healthcare system that can be attributed to musculoskeletal issues such as chronic spine pain, severe back and neck pain and other conditions. Another important point to put across is the significantly high cost of treating bone conditions in one form or the other. Beyond education and awareness, a chiropractor is important in offering advice and recommending how to tackle the growing problem in public health organizations. It is through the sharing of chiropractic expertise that alternative ways of doing things can be adopted. Likewise, it can help ensure that the policies put across include a more holistic outlook that incorporates alternative methods of treatment.
The chiropractic profession can also help improve accessibility to treatment that various professionals offer. This can be achieved by ensuring that at-risk communities and those that boast a high prevalence of these conditions have access to chiropractic professionals at affordable rates (Hawk, 2005). Since the nature of the service tends to be hands-on and very personal, the chiropractic profession can help ensure that sufficient numbers of personnel are trained to ensure that the patient-to-doctor ratio is healthy and sustainable. The need to be at the forefront in advocating for better lifestyle choices such as proper dieting and exercise could contribute significantly in improving the health of the population as well as assist in the formulation of the overall public health policy.
Preventative Measures
One significant role of public health policy is the integration of preventative medicine. Based on this, vast amounts of savings can be made on the already heavily-burdened healthcare system when patients are kept out of hospitals in the first place. Treatment costs are on the rise, and the cost of receiving healthcare is unmanageable for the average patient. Proper weight management needs to be taught, and enough awareness created about its potential benefits. Likewise, people need to know the risks associated with poor weight management. Obesity is a huge public health issue with some communities in the U.S reporting that 60% of their adult populations are either overweight or obese (Porta, 2018). Excess weight puts significant strain on joints and bones and contributes towards inflammation of the affected joints. Over time, this reduces mobility and significantly increases pain and discomfort. A wholesome, balanced diet coupled with regular exercise is the most effective way of managing weight. Various studies and medical professionals agree that at least one hour of exercise a day significantly reduces the risk of obesity and other chronic illnesses.
The design of everyday products needs to be taken seriously. This is particularly the case for products that offer direct support to the musculoskeletal system of the human body. Products such as furniture, shoes, and mattresses need to offer the right support without causing harm over time whilst maintaining their structural integrity. Careful ergonomic design of daily use products can help to alleviate the issues related to body posture, back strain and other forms of pain that put people at risk of developing long-term chronic conditions. Chiropractic professionals ought to be at the forefront of ensuring that manufacturers take into account the long-term medical needs by offering proper posture support from as early as the products’ design phase. Creating awareness about the existence of alternative forms of treatment that complement mainstream medical practices could help lessen the burden on hospitals and reduce the need for invasive procedures. This could open a new realm of possibility for patients to explore other safe forms of treatment without compromising the quality of care. Proven non-invasive procedures used in chiropractic could complement already existing forms of treatment and help reduce the dependence of opioid-based drug treatment procedures that in many cases leave patients addicted to pain medication.
Potential Threats to the Role of the Chiropractic
While the chiropractic profession has seen a rise in growth and prominence over the last few years, new developments could undermine the progress that has been made in the profession. For instance, the emergence of refined robotic surgical procedures has meant that the impact of invasive procedures on patients has been reduced significantly. These new procedures have come with a significant reduction in risk. Numerous scholars argue that these changes have the potential to undermine the growing acceptance of chiropractic. Thus, there is no doubt that emerging technological changes pose a threat to the future of chiropractic (Johnson et al., 2008).
Geographical misdistribution poses another threat to the overall integration of chiropractic practitioners with their mainstream colleagues (Haneline & Meeker, 2011). When specific areas are underserved especially when there is a need for such services, more people will get the opportunity to interact with the profession and the potentially life-changing benefits it offers. The chiropractic profession needs to ensure that more people join its ranks as a means of ensuring that access to services is not limited. Another potential threat is a medical services industry that is increasingly reliant on drugs and invasive procedures. Pharmaceutical companies wield heavy political muscle and often use their vast resources to lobby for terms that enable them to thrive. This potent mix of political and financial resources enables great influence to be wielded over the medical services sector. In some instances, these companies offer medical doctors direct incentives to prescribe certain drugs to their patients.
The Advantages of Public Health Knowledge in the Chiropractic Profession
There are several advantages of integrating public health knowledge in the chiropractic profession. One of the most obvious among them is inclusivity. More people are likely to be reached when a holistic approach to care is adopted especially when it incorporates input from different fields of specialization within the medical sector. The development of better relationships with patients is likely to take place when doctors of chiropractic have some background knowledge of the issues and health threats that affect the communities in which their patients reside. This helps to better inform the decision as to which treatment best suits the medical needs of a particular person, given where they come from. Understanding public health policy can also greatly improve the quality of care that a chiropractic professional offers. This background knowledge helps to create a well-informed and well-rounded professional that has a lot to offer to his/her patients. It is through the standards defined and enforced at the policy level that the quality of care is always guaranteed to patients. Thus, by working hand-in-hand with other professionals, chiropractic practitioners can learn from professionals in other fields of medicine and grow owing to the synergies created by like-minded colleagues drawn from other fields. Preventative care is further enhanced through proactive policies that encourage better lifestyle choices that revolve around balanced nutrition, avoidance of highly processed foods and regular exercise (Haneline & Meeker, 2011). This is likely to result in a population whose health improves significantly, whose healthcare system is less burdened and only offered to those who need it the most.
The Future of Chiropractic and Public Health
The future of the chiropractic profession is dependent on its integration and incorporation in the public health policy as the needs of chronic illnesses among the populace continue to rise. Now more than ever before, there is a need to clearly outline and demarcate the way forward in an inclusive manner in so far as addressing this medical challenge is concerned. The chiropractic profession can offer tremendous support especially with regard to alternative treatment methods and procedures. This is especially important in this era of chronic pain management as musculoskeletal conditions among patients continue to increase (Johnson et al., 2008). Chiropractic institutions of training need to anticipate the need for more professionals. For example, it is projected that more chiropractic practitioners will be required to serve populations even beyond the borders of the U.S. Chiropractic professionals could use the advisory roles to diversify and venture into a broad range of sectors. For example, a practitioner could help advice a manufacturing company on best practices so as to protect its workers against common occupational injuries that occur from overexertion (Haneline & Meeker, 2011).
Conclusion
There is no doubt that chiropractic professionals are bound to gain numerous benefits by interacting and understanding public health. Public health knowledge facilitates the field of the chiropractic by ensuring that these professionals are well rounded. Understanding how the healthcare system works and promoting preventative care goes a long way in ensuring that future generations enjoy good health. By touching base with the potential health risks that affect communities and being an active participant in developing solutions also goes a long way in ensuring that other fields of medicine benefit just as much from chiropractors. Ultimately, this will aid in creating a healthy nation whose people are empowered to strive and achieve greatness from the boundless opportunities that are available to them once their wellbeing is taken care of.
References
Haneline, M., & Meeker, W. C. (20 11 ). Introduction to public health for chiropractors . Jones & Bartlett Learning.
Haneline, M. T. (2007). Evidence-based chiropractic practice (pp. 24-27). Sudbury, MA: Jones and Bartlett Publishers.
Hawk, C. (2005). The interrelationships of wellness, public health, and chiropractic. Journal of chiropractic medicine , 4 (4), 191-194.
Johnson, C., Baird, R., Dougherty, P. E., Globe, G., Green, B. N., Haneline, M., ... & Lisi, A. J. (2008). Chiropractic and public health: current state and future vision.
Porta, M. (2018). A Dictionary of Public Health . Oxford University Press.
Tompa, E. (2002). The impact of health on productivity: empirical evidence and policy implications. The review of economic performance and social progress , 2 .
