partner profile

in their tenures . More generally we are working on a First 100 Days paper ( available in early 2017 ) that highlights five priority areas ASTHO sees as crucialtotheCongressandnewadministration . OurworkwithCongress isongoing , butournextbigeventwillbeourkeyleadershipmeetingthe first weekofMarch . Ithink allofus engagedin public healthhaveaduty to educate our policymakers on the impact of our work and the need to sustain andstrengthenthat work . Ilike tosaythateveryminuteweare not on the Hill advocating for public health , someone else is filling that voidwiththeirownprogramadvocacy .

What do youconsider tobe thetop challengesfacingtheUSpublic healthsystemin2017 ?

Wehavealotofchallenges ! First , akeyissuewillbecontinuedefforts to tellthepublichealthstorytoanewadministrationandCongressto sustaincurrentpublichealthinvestments . Second , Ithinkwemustdoa betterjobthinkingaboutalternativestrategiestoaddresshealthreform andaccesstohealthcareiftheAffordableCareActgoesaway . Whatare we suggesting as essential elements of a new health coverage plan ?

WhileIknowthereisabigdifferencebetweenpublichealthand healthcare delivery , we cannot ignore that most of the “ action ” is in healthcaredelivery . Howarewepositioninghealthagenciestoaddress population health and to take part in discussions of healthcare access , delivery and , importantly , upstream prevention ? What are we doing to link public health and healthcare in the states ? Of course , there are continued challenges related to public health workforce development and retention and pressure to cut governmental public health funding even whenthereisgreatneed . Iaminterestedinhowweadvanceourworkon health equity — an issue often incorrectly perceived as partisan . Finally , Iwouldsayachallengeisourcontinuedneedtorespondtopublichealth emergencies . Naturaldisastersandinfectiousdiseasesposechallenges as well as opportunities to build support for the critical role public health plays in states and territories .

Is current public health funding sufficient to address these challenges ?

No . Next question ?

But seriously , there is tremendous need . As we spend more and more on healthcare delivery we have to make the case that investments in prevention are highly cost-effective and sometimes even cost-saving . If we cannot quantify that , we are sunk . We must get better at advocating forsustainedandincreasedinvestmentsusingeconomiclanguage , as wellascompelling storiesaboutthe impact of ourwork . Itisnotokay that many states do not benefit from core public health programs funded by CDC because funding is not available for all states . It is not okay that we are cutting staff in our health departments at the very time we need to strengthen our health system to address public health threats like Zikavirus , environmentalhazardsandstubbornlyhighratesofchronic disease . Wehavetobetterlinkourworktothehealthcaredeliverysystem where the bulk of our health dollars are spent and show the return on investmentthatpublichealthpayswhenproperlyresourced . Letmejust add that we must stop talking to ourselves about this — the wringing of handsandgnashingofteethmaybefamiliartous , butweneedtoengage policymakers and others who can impact health agencies ’ bottom lines . Thereisalotto do inthisarea for sure . And no oneisgoingto do itfor us .

Howcanweexpeditefederalfundingforresponsetofuture publichealthemergenciesinthewakeofdelayedfundingfor

Zika response ?

We should work more closely with our elected representatives to demonstrate the urgent need for these funds and move public health appropriations for emergency response into a more accessible mechanism . ASTHO supports an adequately resourced Public Health Emergency Fund that jurisdictions can tap after reaching certain epidemic thresholds or experiencing public health emergencies . Thereisnoreason Zikafundingshouldbe heldhostage in political fights about other issues . Preventing the deleterious effects of an infectionlikeZikaisclearlynonpartisan . Let ’ screateafundand assure accountability for it while simultaneously getting it outside the political process . I think we have a lot to learn from the Federal Emergency Management Agency on this one .

How can we strengthen connections within state health programs , e . g ., emergency response , epidemiology and lab ? Are there states

that serve as models in this regard ?

OnethingIhaverealizedoverthecourseofmanyyearsworkingin public health and healthcare is that we are truly tribal . We love our silos , where we have our funding , our expertise , our professional identity . But the challenges of today and tomorrow are multi-sectorial anddonotpresentinsilos . TakeZika , forexample : itimpacted infectious disease control , epidemiology , maternal and child health , laboratory practice , vector control , public health preparedness and other public health programs . Can we use the Zika crisis as a model for cross-agency collaboration in the future ? I hope so .

How can APHL and ASTHO work more closely together ?

IappreciatewhatAPHLmembersbringtostateandterritorialpublic health and the core function they play in the public health enterprise . We start there . I have deep respect for APHL ’ s staff and leadership andagoodworkingrelationship . Thatrelationshipallowsustobuild trust andmove quicklywhen weneedtoact together . Certainly , state andterritorialhealthofficialshavevariedlevelsofknowledgeof governmental laboratories and the highly technical work they do . I think APHL and ASTHO can work more closely together on orientations for new state and territorial health officials , using APHL resources to bringASTHOmembersuptospeedonlaboratoryfunctions , challenges andopportunities . Ofcourse , Iwouldliketoseeusdomoretogether ontheadvocacyside . Anotherareaforcontinuedexplorationishow weworktogetherontechnologyprojects , suchasourelectroniccase reportingprojectand “ DigitalBridge .” IwouldalsoliketoseeASTHO work more closely with APHL on global issues , such as working with ministriesofhealthinresource-limitedcountries . Thereismuchtodo , andIamexcitedtodoitwithAPHL .