Reimagining and Transforming Governmental Public Health Infrastructure and Systems

The 21st Century Learning Community (21C) is a group of states systematically working to transform their governmental public health systems, and PHNCI convenes these states to provide support and a space for them to share, generate efficiencies, and learn from one another’s successes and failures.

Health departments provide public health protections and services in a number of areas, including preventing the spread of communicable disease; ensuring food, air, and water quality are safe; supporting maternal and child health; improving access to clinical care services; and preventing chronic disease and injury. As discussed in December’s blog, Now is the Time for the Foundational Public Health Services (FPHS), the FPHS framework outlines these protections to help states transform and modernize their public health systems. In the past month, PHNCI has further developed its transformation activities to build and strengthen governmental public health infrastructure and systems to create change that improves health. These efforts require centering equity, modernizing data systems, and equipping health departments with the Foundational Capabilities and workforce needed to serve, rebuild trust, and be accountable to their communities. 

Public Health Infrastructure 

It has become evident that public health systems nationwide are deeply inadequate – the infrastructure, workforce, and systems needed to provide essential functions are outdated, insufficient, and in dire need of transformation. Since health departments serve their communities 24/7, they require the necessary infrastructure to access a wide range of critical data sources, robust laboratory capacity, and preparedness and policy planning capacity, as well as the expert staff to leverage them in support of public health protections. This important public health infrastructure consists of Foundational Capabilities, which are the cross-cutting skills and capacities needed to support basic public health protections, programs, and activities key to ensuring community health, well-being, and achieving equitable outcomes. This month, PHNCI will release the revised FPHS framework – stay tuned for that update in the coming weeks.  

The Foundational Capabilities also support essential community-specific services, which are local protections and services unique to specific needs of a community and are determined to be of additional critical significance to that community’s health. The FPHS framework continues to serve as the basis for transformational efforts across public health systems, and with accreditation administered by the Public Health Accreditation Board (PHAB), there is an opportunity to foster accountability through the PHAB Standards & Measures, which now explicitly indicate which requirements relate to the Foundational Capabilities.  

Accountability 

PHAB accreditation is a voluntary way for health departments to show that they deliver quality essential services to their communities, which can foster trust in public health department performance and increase accountability and transparency among community members. Now that the Foundational Capabilities are explicitly integrated into Version 2022 of the PHAB Standards & Measures, which will be released soon, communities served by accredited health departments can feel assured that their health department is equipped to provide the capabilities and meet their basic needs. Additionally, communities can feel confident that their health department is centering equity, prioritizing community partnerships and collaboration, and continuously improving policies and practices based on evidence and data. In fact, 79% of accredited health departments said that accreditation has improved the health department’s accountability to external stakeholders1. The more communities understand the value of and rigor behind their public health departments, the more likely trust can be built in their support for public health. 

Call to Action

The 21st Century Learning Community (21C) is a group of states systematically working to transform their governmental public health systems, and PHNCI convenes these states to provide support and a space for them to share, generate efficiencies, and learn from one another’s successes and failures. Are you ready to take the next step in your state’s public health transformation journey? Apply to be a part of 21C today! Interested states must be taking a state-wide systems approach towards transformation and modernization efforts of infrastructure and systems; focusing on developing equitable public health systems and communities; and implementing a vision and strategy for transformation and modernization that has been conceptualized across key public health stakeholders. Click here to learn more or reach out to Reena Chudgar, PHNCI’s Director of Innovation, at rchudgar@phnci.org for more details. 

1The Value and Impact of Public Health Department Accreditation: A Review of Quantitative and Qualitative Data, Public Health Accreditation Board, June 2021. www.phaboard.org/wp-content/uploads/PHAB-Value-and-Impact.pdf

Author Profile

Travis Parker Lee
Travis Parker Lee, MBA, is a Senior Specialist at PHAB, where he leads and supports programs within the Public Health National Center for Innovations. Previously, he served as a Program Specialist for PHAB, where he implemented various aspects of the public health department accreditation program. He holds a Master of Business Administration degree from the University of Maryland Global Campus and a Bachelor of Science degree in Public Health Education from James Madison University.