COVID-19 brings lessons for public health infrastructure

The COVID-19 pandemic has identified gaps in public health infrastructure related to chronic underfunding. However, the pandemic has also opened up opportunities to strengthen the founding capacity of public health facilities in the United States, the report said in a special appendix to Journal of Public Health Management and Practice.

« pandemic the answer stressed the importance of having a reliable public health infrastructure which is well supported in areas of fundamental opportunity, “said Maria Kurgen, MPH, of the Washington Department of Health and colleagues. The article is part of a special issue public health transformation and innovation.

“Reload course for basic health services”

Kuragen and his colleagues describe the efforts of three states – Ohio, Oregon and Washington – to develop and promote Fundamental Health Services (FPHS), defined as “a minimum package of public health capabilities and programs without which no jurisdiction can exist.” In 2016, three states received funding to define, measure, and advocate for a public health system. The authors write that “the pandemic has revealed the consequences of insufficient investment in public health” and “brought opportunities to accelerate the work of FPHS and problems for its progression.”

• In Ohio, the pandemic highlighted the training and technical assistance needed by local health departments to obtain PHAB accreditation – a unique requirement of state law. However, efforts to fill gaps in FPHS are compounded by a lack of funding, while recent policy changes will have “far-reaching unintended consequences” for the ability to respond to future threats of infectious diseases.
• In Oregon, COVID-19 drew attention to existing public health modernization initiatives targeting high-risk populations systematically inadequate for the health care system. Lessons from the pandemic include increased preparedness to respond to multiple simultaneous threats to public health, increased integration with joint partnersas well as initiatives that favor health and justice.
• In Washington, investment in health care before the pandemic was “relatively small” compared to estimated gaps. Following COVID-19, public health leaders worked to increase the knowledge and appreciation of FPHS, motivating increased funding to meet these needs. Other outcomes included the creation of a new Health Advisory Board and new requirements to diversify local health councils to include community members and health experts.

States ’work on“ defining, measuring, and promoting FPHS proved helpful when it came time to respond to a pandemic, ”Kurogen and colleagues write. “Ohio, Oregon and Washington are resetting the FPHS course to adequately fund and measure progress in these foundational opportunities.” These three states are next to 16 others in PHNCI’s 21 PHAB^street Century Learning Community, focused on promoting the transformation of public health.

Professionals and politicians have the task of “seizing the opportunity to rethink public health,” said Rina Chadgar, MPH, and Jessica Solomon Fisher, MCP, of PHNCI and PHAB. “We need to work together, collaborate with cross-sectoral partners, and share and transfer power with the communities we serve to find solutions to transform public health practices.”

According to Paul Kuhnert, DNP, RN, FAAN, with PHAB and his colleagues, the recently revised 2022 FPHS “provides clarity for the reform needed in our U.S. health care system.” “The pandemic has demonstrated the critical need and importance of a strong health care system and infrastructure,” they write. “We have a rare opportunity to use the interests of politicians and federal funding to transform and modernize the public health in the United States. ”