Recommendations for Building a National Public Health System That Addresses Ongoing and Future Health Crises -- Commonwealth Fund Commission study

MEETING AMERICA’S
PUBLIC HEALTH CHALLENGE
Recommendations for Building a National Public Health
System That Addresses Ongoing and Future Health Crises,
Advances Equity, and Earns Trust
The Commonwealth Fund Commission on a National Public Health System

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The United States should build a national public health
system to promote and protect the health of every person,
regardless of who they are and where they live; implement
effective strategies with others in the public and private
sectors; respond to both day-to-day health priorities and
crises with vigor and competence; and, in the process,
earn high levels of trust. In this report, the Commission
provides a detailed set of recommendations to achieve
this vision, which include the following:

Congress should:
• Establish a position, such as an undersecretary for
public health at the U.S. Department of Health and
Human Services (HHS), to oversee and coordinate the
development of the national public health system.
• Provide adequate and reliable public health
infrastructure funding, paired with expectations that
states, localities, tribes, and territories meet standards
for protecting their communities.
• Fund a modern public health information technology
system and provide HHS with the authority to make
it work.
The Administration should:
• Set parameters for use of available funds to
systematically build public health infrastructure,
with an initial focus on workforce and data systems.
• Support revision of accreditation standards for state,
local, tribal, and territorial health departments
to focus on basic capabilities for public health
protection.
• Establish a council to coordinate federal public health
action with states, localities, tribes, and territories.
• Reconvene the National Prevention and Public Health
Council to guide an all-of-government approach to
the drivers of health.
• Embrace ethics, integrity, and transparency in
decision-making in public health.
States, localities, tribes, and territories should:
• Assess the structural and policy changes needed
to provide foundational capabilities for all their
residents.
• Build connections between the health care system
and public health to strengthen day-to-day health
improvement efforts and better prepare for
emergencies.
• Involve community partners in decision-making
about public health.
Modernizing public health in the United States is not a
simple task, but it cannot be ignored. The window for
change is open, and the moment of opportunity is now.

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