Public health issues require significant investments


In summary

We cannot wait for the next pandemic or public health crisis to emerge; we still face a host of other public health issues.

By David Souleles, special for CalMatters

David Souleles is Director of the COVID-19 Response Team at the University of California, Irvine and Director of the Masters in Public Health Curriculum and Practice at UC Irvine.

As a public health practitioner with over 35 years of experience in public health in California, it is my duty to call attention to the urgent need for a significant investment in our workforce and our public health infrastructure.

Public health has always struggled with three key issues: understaffing, underfunding and misunderstanding. The pandemic has claimed the lives of nearly one million Americans — a devastating but preventable loss had public health agencies been better equipped with the proper resources, personnel and infrastructure.

When COVID-19 eventually becomes rampant, we are still left with a host of other public health issues, including over 480,000 tobacco-related deaths; rising rates of chronic disease; a record level of sexually transmitted infections; and disparities in maternal and child health problems and birth outcomes. At the root of all public health issues are long-standing issues of equity and access.

The Great Public Health Exodus

Since 2008, the National Association of County and City Health Officials reports that local and state health departments have lost nearly a quarter of their workforce, and another 25% plan to leave the profession within a year. year.

Analysis by Kaiser Health News and the Associated Press revealed that more than 180 state and local public health officials have resigned, retired or been fired since April 1, 2020, in what experts are calling the largest exodus from public health workers on the ground in our country. the story. The report says nearly 40 million people reside in a community that lost its local public health official during the pandemic. Overwhelmed, exhausted and facing personal threats and heightened political pressure, public health officials have been driven out at an unprecedented rate – just when we need them most.

Investing in public health to improve and maintain community health

Investing in a vibrant and skilled workforce is one step in a multi-faceted approach to rebuilding public health organizations. The other is to invest in the systems and technologies that make up the public health infrastructure. Serious investments in disease notification technologies, public health laboratories, public communication systems and health service facilities are needed to enable public health professionals to be effective.

Public health is preventive health, and measures such as ensuring adequate sanitation, clean air and clean water, and vaccination against infectious diseases have essentially doubled human life expectancy over the past of the past 200 years.

Research shows that investing in public health brings high returns and impactful results. According to the World Health Organization, population-level approaches are valued costs five times less than individual interventions and, in general, investments in public health return four times more for every dollar invested.

The power of health policy

I applaud Governor Gavin Newsom proposed budget for 2022-23 which allocates $300 million to state and local public health agencies to build capacity and transform California’s public health system.

This investment would strengthen staffing, data collection and expand local partnerships with health care delivery systems and community organizations. It would also help improve public health infrastructure statewide by investing in resources for emergency preparedness and improving communication, public education and countering misinformation.

This is the action we need. And it can also help other states develop their own roadmap for building public health capacity. This proposal happened because public health experts were at the table with policy makers. This is proof that we must continue to build relationships with government officials and continue to work through our professional associations. We need to talk about science and counter anti-science narratives. We need to talk to our networks and communities to build trust and support. We have to vote. And we need to find a way to speak with one voice to be better advocates for public health.

We cannot wait for the next pandemic or public health crisis to emerge to invest in the future. By now this lesson should be learned.


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