Maintaining the relevance of public health within the wake of the Affordable Care Act: How the socio-ecological model might just save us from the medical model of public health

In the wake of the passing and incremental implementation of the Patient Protection and Affordable Care Act (ACA), some have voiced concerns about maintaining the relevance of public health, particularly the relevance of state and local health departments. This concern stems from the idea that with a significant increase in the number of individuals covered by health insurance and an increase in preventive service provisions offered through health insurance coverage, there is less of a need for “traditional” public health services. This concern is based in an overly medicalized narrative of public health. The medicalization of public health distracts from the numerous significant contributions of public health outside of primary care and clinical preventive care. As such the potential controversy surrounding public health in light of the ACA revolves around the possible negative public and population health outcomes resulting from the over-medicalization of public health overshadowing other public health priorities, responsibilities, and efforts. Therefore, public health organizations, workers, and advocates must make explicit a reallocation of public health priorities and activities within the context of the ACA. This can take place by way of increased attention to the way community initiatives, education initiatives, urban planning and built environment initiatives, and public health policy initiatives contribute to the public's health within a socio-ecological narrative of public health.