Public Health Intersection

The more things change, the more they stay the same

We’ve just come through our initial tangle with novel influenza, (remember swine flu, Spanish flu)

We’ve seen recent terrorist attacks, (remember the Maine, the Cole, 9/11)

We’ve seen that natural disasters can still change the face and structure of society, (too many tsunamis, tornados, hurricanes and earthquakes to remember)

We’ve seen the national efforts at health insurance reform go through a continuing saga of twists and turns, (remember Medicaid, Medicare, and other less successful legislative efforts)

We’re entering the second year of a new federal administration; we’re coming up on mid-term elections, (1994 comes to mind)

In those states with term limits, like California, we’ll be electing a new Governor.

My question in the midst of all of this is, “Where’s governmental public health?”

I think we’re where we have been most of the time in many of the instances noted above…in the thick of things.

But are we societies anchor, assuring that people and communities are safe and protected from health threats, or are we flotsam being carried along by the events of the day.

In 2000, the US Congress passed the Public Health Improvement Act, (PL 106-505), or Frist/Kennedy or Kennedy/Frist, depending upon your political persuasion.

For all intents and purposes it was a victory for governmental public health that was quickly eclipsed by the attacks on 9/11 and anthrax poisonings that resulted in a more narrow focus on bioterrorism and emergency preparedness.

The original bill provided up to $50 million a year for 5 years to;

• Train public health personnel
• Develop, enhance, coordinate or improve participation in an electronic network by which disease detection and public health related information can be rapidly shared among national, regional, state and local health agencies and health care providers
• Develop a plan for responding to public health emergencies, including significant outbreaks of infectious diseases or bioterrorism attacks, which is coordinated with the capabilities of applicable national, state and local health agencies and health care providers
• Enhance laboratory capacity and facilities.

The good news is after 9/11 governmental public health received a lot more money than $50 million a year.

The bad news is, the resources were focused on building a response system rather than building a sustainable infrastructure for governmental public health.

There were lots of good things in that 2000 law, many of them are certainly still in play today, (think HITECH).

However, it seems like government al public health is now the flotsam when it comes to training, health IT systems, health reform and the like, just being carried along by the tide.

Let’s look for and take advantage of opportunities to establish governmental public health as a priority whether things change or stay the same.