Our nation's public health workforce sprang into action to save millions of lives during the COVID-19 pandemic. From delivering masks to essential healthcare workers to rolling out mass vaccination campaigns, they fought to keep us safe.
Rather than focusing on providing state and local public health agencies with support however, many state legislatures hastily introduced bills that weakened the ability of public health agencies to protect the communities they serve.
State and local public health agencies are entrusted with the power to make decisions around public health emergencies as well as day-to-day public health needs. This includes decisions about how to prevent the spread of disease. Examples of this include designing vaccination requirements for school children to protect against deadly illnesses like measles and polio, and issuing health orders such as quarantines to stem infectious disease outbreaks when a public health emergency is declared.
Public health agencies also establish regulations that promote healthy communities such as ensuring everything we eat and drink is clean and safe, preventing injuries in the workplace, and guaranteeing safe, stable housing. They also ensure compliance with those regulations through inspections and licensing.
State and local public health agencies have this authority because they possess the best understanding of community health needs and keep up with the latest health research. Public health agencies are not infallible and deserve thoughtful critique especially as it relates to equity, but by and large they exercise their unique authority with great care.
At the heart of the legislation restricting public health measures is the notion that public health agencies have taken on decisionmaking authority that should be reserved for elected officials—members of Congress, state legislatures, and other locally elected bodies. But just as you wouldn’t ask a politician to step in for a firefighter and put out a fire, it does not make sense for a politician to take over for a public health official and contain an outbreak. Public health is best served when decisions are driven by expertise, experience and evidence, and when public health officials demonstrate transparency and accountability.
State and local health departments and the communities they serve are finding new ways to navigate this shifting landscape with support from public health law experts, the Robert Wood Johnson Foundation, and others, as the 2023 state legislative sessions begin.
From their efforts, three things strike as worth paying close attention to as we chart a path toward a stronger public health system:
There is no question that we must fix the gaps found in our nation’s response to the COVID-19 pandemic to create a more just, effective public health system. But we should be finding ways to strengthen public health officials’ ability to do their job—not blocking them with more red tape.
Matt Pierce, senior program officer, works in the areas of public health law and tobacco control. He is interested in finding more equitable ways to promote health and wellbeing.
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