This chapter of The Future of the Public’s Health in the 21st Century explores the state of governmental public health infrastructure, including the role of federal, state and local governments in health promotion. It advocates for public health law reform and uniformization and outlines the critical components of public health infrastructure.
Public Health Authority
The authority to act to protect and promote the public's health has emerged over the course of our Nation’s history, and has enabled many of modern public health’s greatest achievements. Today, public health agencies use their authority to promote health, prevent the spread of infectious disease, protect against environmental hazards, advance equity and assure local public health infrastructure and health services. During declared emergencies, state and federal authorities have broader powers to act to assist governments, suspend or modify legal requirements, pass and enforce law and expend funds for the health, safety and welfare of society. Recently, some states have moved to limit public health powers. Such efforts pose a mounting challenge for public health’s response to COVID-19 and future threats.
Public Health Workforce Development and Diversity
The public health workforce plays an essential role in securing the vital conditions for health and well-being for all to thrive. A skilled, resourced, and robust public health workforce is needed to meet the demands of public health today and prepare for the needs of tomorrow. A diverse public health workforce is better equipped to address the needs of the most impacted and marginalized, and implement population health strategies. COVID-19 has shed light on challenges facing the public health workforce, while also exacerbating them. The COVID-19 pandemic has emphasized the need to skill up the workforce; support workers’ needs; center equity in workforce development efforts; and plan for the future.