PUBLIC HEALTHModernizing U.S. Public Health: What Needs to Be Done

While much of the past 20 months has focused on the response to and treatment of COVID-19, it has also brought to light the challenges faced by our nation’s public health systems. The federal government has made substantial investments to bolster governmental public health capacity and respond to the pandemic, but our nation is at a crossroads to set a new course for public health and rectify decades of under investment. The Bipartisan Policy Center (BPC) and nine of the nation’s top public health associations and foundations issued a five-year roadmap for state and local elected officials and public health leaders to build a more equitable, robust, and sustainable public health system.

Public Health Forward: Modernizing the U.S. Public Health System outlines the critical investments needed to modernize the public health system so that the United States becomes a healthier nation, able to respond to an array of public health challenges—future pandemics, mental illness, substance abuse, obesity—all while ensuring every American has the opportunity to achieve their best possible health and well-being. The recommendations were shaped by a bipartisan task force of current and former governors, mayors, elected representatives, nonprofit, public health leaders, and health care executives.

Concerns about the current public health system are pervasive. National Institute of Allergy and Infectious Diseases director Anthony Fauci recently said that “public health infrastructure is not modernized.” Former U.S. Surgeon General Jerome Adams expressed his concerns as well: “I’m worried, quite frankly … that we haven’t really come to the place where we understand we need to invest in public health, we have to invest in a public health workforce.” What can – and should – be done?

BPC and the Public Health Forward coalition calls on state, territorial, and local policymakers and health departments to use this unique opportunity to advance the nation’s health equity, safety, security, and economic prosperity through investments in public health.

The report recommends policymakers and public health departments implement the following actions to build a modern public health system:

·  Financing: provide flexible funding and maximize existing assets to support public health services and capabilities and evaluate the social and economic impact of public health programs and strategies.

·  Data and Information Technology: strengthen the collection of prompt and actionable public health data and invest in data sharing between public health departments and health care entities.

·  Workforce: invest in the recruitment and retention of a diverse and inclusive governmental public health workforce. Improve hiring and promotion policies and processes to ensure high-quality public health services.

·  Public Health Laws and Governance: review, evaluate, and modernize public health governance structures and statutory responsibilities. Support and clearly communicate the roles of public health departments to the public.

·  Partnerships: incentivize partnerships between public health departments and other sectors and stakeholders. Establish a dedicated body charged with routinely monitoring, assessing, and influencing the implications for health in all government sector policy discussions.

·  Community Engagement: invest in long-term relationship-building and partnership development with residents and community-based organizations and in Tribal consultation. Invest in increasing the capacity of community-based organizations and provide resources to support collaboration with public health departments.

“No health challenge facing America – from the pandemic to the opioid crisis and mental health to diabetes and obesity – can be surmounted without a well-resourced, staffed, technologically connected public health system which fosters partnerships and engages communities,” said Dr. Anand Parekh, BPC’s chief medical advisor, who led the project. “It’s time we no longer take public health for granted.”