Measles, opioid overdose, health disparities, chronic disease, avian flu – these are all major health challenges the US faces. Public health officials at all levels can help address these urgent issues, but a 21st-century approach is needed, according to the National Academy of Medicine’s Vital Directions for Health and Health Care report.
The National Academy of Medicine releases the series every four years to coincide with presidential administration changes to help guide actions on health care policy.
What’s holding back public health
Public health faces a number of obstacles that make it difficult to provide support that can “enable communities and the people in them to live healthier, better lives,” said Dr. Mark McClellan, co-author of the NAM’s road map for public health, published in Health Affairs. McClellan, director of the Duke-Margolis Institute for Health Policy at Duke University and former head of the CMS and FDA, noted that lack of data and infrastructure, in addition to difficulties getting timely data, can hamper public officials’ ability to collaborate and respond to health concerns. Add in weaknesses in the workforce, fragmented funding, inconsistent support beyond emergencies and eroding trust in public health and its institutions, and it’s easy to see that public health is in need of modernization.
Reports highlight current challenges
Recent reports show the need for updating public health systems. The Pew Charitable Trusts surveyed 300 public health officials in 47 states, finding major differences among states in data reporting. Most states do not require electronic data collection and none require automated reporting of case reports. However, while many health departments have begun to gather data electronically, but there would be greater benefits if the technology was more widely adopted.
Additionally, shortages in the public health workforce are straining jurisdictions across the US, hindering essential functions like disease investigation and emergency response, a Government Accountability Office report found. Recruitment and retention are serious problems across occupations in the field.
What a modernized public health system looks like
Despite these challenges, the NAM report noted there is an opportunity to bring public health into the modern era by focusing on collaboration and coordination. A range of perspectives from business, health care and community organization leaders can help form common goals based on data, McClellan said, highlighting best practices from local authorities that were used to develop recommendations to improve public health, including:
- Enhancing automated reporting: Making data available systematically via increased use of electronic health data can give local and state officials a better understanding of trends in their communities.
- Using metrics: Data from reporting can help officials create metrics to track concerns and see variations across neighborhoods and populations. They then could tie that information to health care, social work and other organizations that are trying to address public health issues, while also emphasizing disease prevention and the importance of primary and community care.
- Leveraging cross-sector collaboration: Community collaborations can take advantage of funding sources and emerging data to identify and tackle public health concerns across sectors.
- Supporting training programs: Public health is a team sport, and as such training programs can improve public health capabilities and ultimately extend the reach and impact of these efforts.
McClellan and his co-authors emphasized that following these recommendations “would enable significant improvements in population health outcomes and reductions in health disparities and provide a stronger foundation for a ‘team-based’ future public health enterprise.”