Public health leaders are lauding HHS' call for money and data to drive stronger health initiatives that take into account social determinants.
HHS said in a white paper released Tuesday that funding reductions have strained local public health agencies and prevent them from addressing issues such as HIV prevention and infant mortality in some of the country's poorest communities.
The paper, which outlined the initiative called Public Health 3.0, looks at income, ethnicity, sexual orientation, gender identity and place of residence. The initiative is the next step of the Obama administration's Healthy People 2020.
“Today, a person's ZIP code is a stronger determinant of health than their genetic code,” HHS acting Assistant Secretary Karen DeSalvo said in a blog post. “In a nation as wealthy as the United States, it is unconscionable that so many people die prematurely from preventable diseases; even worse are the health disparities that continue to grow in many communities.”
Recommendations call for local health departments to become “chief health strategists” and develop partnerships with community groups to promote health.
Dr. Georges Benjamin, executive director of the American Public Health Association, said the recommendations (PDF) validate his work and that of his colleagues.
“I was really excited at the fact HHS took the leadership role to say once and for all we're going to have a sound governmental public health system that allows us to address population health,” Benjamin said. “Once you do that you're really able to leverage a lot of things.”
Benjamin said the report underscores how unstable housing, unemployment, violence and unhealthy food disproportionately affect people in poorer communities.
HHS also recommended timely data be made accessible to communities to assess the impact of public health initiatives.
Local health departments were also urged to come up with new incentives to recruit and retain staff. Public health departments around the country have faced staffing challenges as the result of state budget cuts. Since 2008 more than 51,000 positions at local health departments were eliminated through either layoffs or attrition, according to a July report by the Centers for Disease Control and Prevention.
“Right now most of our health departments in the country don't have the full capacity to do what they should be doing each and every day—things that they know they should being doing each and every day,” Benjamin said.
