ACP calls for modernizing public health infrastructure

It is imperative that we augment and enhance the public health infrastructure in the United States in order for it to achieve its mission of preventing illness and promoting health, says the American College of Physicians (ACP) in a new policy paper published July 17 in the Annals of Internal Medicine. "Modernizing the United States' Public Health Infrastructure: A Position Paper from the American College of Physicians" updates recommendations ACP made in 2012 for the U.S. public health infrastructure with new policies on establishing federal public health leadership, protecting public health workers, reversing workforce shortages, and the need to integrate primary care and public health.

"Over the past several years we have seen how deficiencies in our nation's public health infrastructure left us unprepared to face a major public health crisis," said Omar T. Atiq, MD, FACP, president, ACP. "COVID-19 has demonstrated why we need to ensure that we are fully equipped to respond to future public health emergencies and also how better support for public health in the interim can safeguard the health of everyone in our country."

In the new paper ACP recommends that the U.S. Department of Health and Human Services (HHS) designate a new public-health official who would coordinate interagency work and be responsible for public health efforts. It recommends immediate action from Congress to provide sufficient and stable funding for public health at the federal, state, and local levels. The paper also calls for action to address the severe shortage of public health workers. The number of public health workers employed by state and local governments declined by 15% from 2011 to 2021, and a survey of state and local public health found that 27% of workers intend to leave their position within a year.

ACP's paper calls for increased efforts to combat health-related dis- and misinformation, especially through social media platforms. The paper recommends the development of a national public health data system that would be capable of sharing real-time information back and forth between public health departments, physicians, hospitals, laboratories and others. Finally, ACP encourages collaboration between public health and primary care.

In an accompanying editorial also published in Annals, Sherri A. Berger, MSPH and Rochelle P. Walensky, MD, MPH reflected on ACP's paper from the perspective of the Centers for Disease Control and Prevention (CDC). In the piece they say the CDC, and their state and local public health partners, are heeding the call to take concrete action, and they further caution that the CDC cannot act alone, and, without funding, flexibility, and new authorities.

"Physicians and public health professionals have a shared mission. We need to work together to improve the health of the American public most effectively," concluded Dr. Atiq. "Public health has long been underfunded and underappreciated, the crucial nature of this work means we need to act now to make changes to reverse that and modernize our public health infrastructure."