The Future of Public Health Three Things to Watch for in 2023
Skip to main content
Robert Wood Johnson Foundation
  • Our Mission
    • Our Mission Overview
    • Why Health Equity
    • Focus Areas
    • Measuring RWJF Progress
    • Activation test
  • Grants
    • Grants Overview
    • Active Funding Opportunities
    • Awarded Grants
    • Grantee Stories
    • Grant Process
    • Grantee Resources
  • Insights
    • Insights Overview
    • Blog
    • Our Research
    • Advocacy And Policy
  • About RWJF
    • About RWJF Overview
    • Our Guiding Principles
    • How We Work
    • Impact Investments
    • Staff And Trustees
    • Newsroom
    • Careers
    • Contact Us
Find A Grant

    The Future of Public Health: Three Things to Watch for in 2023

    Blog Post Feb-03-2023 | Laura Leviton , and Alonzo L. Plough | 4-min read
    1. Insights
    2. Blog
    3. The Future of Public Health: Three Things to Watch for in 2023

    To strengthen response to current and future pandemics, local policymakers and public health officials need to cut through red tape. Here are three things that may impact their ability to do so this year.

    Public health illustration.

     

    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.

     

    US State Legislation chart.

    Source: Temple University Center for Public Health Law Research

     

    What is Public Health Authority?

    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.

    What to Watch in 2023

    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:

    1. Bright spots: Last year, 12 states passed 17 laws expanding emergency authority. These included Colorado, which tasked the state board of health with overseeing a stockpile of personal protective equipment, and Pennsylvania, which removed decades-old restrictions on public health decisionmaking to keep new measures introduced during COVID-19 in place. These kinds of laws will help ensure that public health officials can nimbly respond to a crisis, trusting that their decisions will strike the right balance between the common good and individual rights. And it means these states will be one step closer to having the right leadership, funding, and other resources to drive effective public health practice every day. Additionally, a number of states have formed public health commissions or task forces to conduct a comprehensive, thoughtful review of the powers and duties of state and local public health departments—some authorized by the state legislature or by a governor’s executive order. These groups are beginning to issue recommendations for consideration in their state legislatures. Hopefully, we will see more states demonstrating support for the critical role public health plays.
    2. Ongoing threats: Looking at trends from last year’s legislative sessions, we should anticipate vaccines remaining in the spotlight, with more attempts to limit childhood vaccine requirements and a broader embrace of religious and personal beliefs as a reason to object to them. In fact, bills to limit health department authority over vaccines required for school attendance have already been introduced in Indiana, Missouri, and Texas. Another troubling bill introduced in Kansas would remove the state health officer’s authority to issue orders including isolation and quarantine orders or make rules related to the spread of diseases. Given the pace of legislation introduced in these five states last year, we should also expect to see more threats to public health authority emerge in Arizona, Tennessee, Kentucky, Montana, and Arkansas.
    3. Litigation: The number of lawsuits that have been filed around the country challenging public health orders has been unprecedented. While most courts are siding with public health in cases related to COVID-19, some courts are narrowing public health’s decisionmaking authority and looking more favorably on religious liberty claims. This is a significant shift from a historical deference to public health expertise and science, and cause for alarm. Looking ahead, there are still many lawsuits still to be settled and the possibility of new cases challenging public health decisions on the horizon.

    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.

    Stay informed about what’s happening in your state and how you can take action to strengthen public health.>>

    Matt Pierce, Robert Wood Johnson Foundation

    About the Author

    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. 

    +

    SHARE

    Subscribe to receive Funding Alerts & more

    Explore the latest in reflection and research from subject matter experts at RWJF and our wide network of partners.

    Email address already subscribed. Please check your inbox to manage your subscriptions.

    Subscribed!

    Thank you. You are now subscribed.

    Tell us what type of content you want to receive.

    Be informed with our weekly newsletter updating you with relevant news and research around a Culture of Health, as well as the latest funding opportunities.

    Get funded by RWJF: Receive notifications when new funding opportunities are released.

    Receive monthly updates on RWJF-sponsored research that informs many robust health policy debates on Capitol Hill, covering topics like health equity, improving access to quality healthcare, equitable housing, and more.

    Shop talk for researchers. This monthly newsletter covers research news and opportunities from the Robert Wood Johnson Foundation.

    Sometimes we have news, announcements or opportunities that don't quite fit the subscription parameters above. If you're interested, we'll send you this information under "There's more...". *If you've indicated you are an EU resident, we will only send these communications if you intentionally check this box.

    Yes! I want to tell you more about myself and receive personalized communications in the future.

    Area(s) Of Interest

    Which profession or pursuit best describes you?

    Unsubscribe

    Stop receiving all emails from RWJF

    This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
    • CONTACT RWJF

      50 College Road East

      Princeton, NJ 08540-6614

       

      US Toll Free: (877) 843-7953

      International: +1 (609) 627-6000

    • MANAGE YOUR GRANTS

      MyRWJF Login

      • Twitter link
      • Facebook link
      • LinkedIn link
      • YouTube link

    • Our Mission
      • Our Mission Overview
      • Why Health Equity
      • Focus Areas
      • Measuring RWJF Progress
      • Activation test
    • Grants
      • Grants Overview
      • Active Funding Opportunities
      • Awarded Grants
      • Grantee Stories
      • Grant Process
      • Grantee Resources
    • Insights
      • Insights Overview
      • Blog
      • Our Research
      • Advocacy And Policy
    • About RWJF
      • About RWJF Overview
      • Our Guiding Principles
      • How We Work
      • Impact Investments
      • Staff And Trustees
      • Newsroom
      • Careers
      • Contact Us

    ©2001- 

    Robert Wood Johnson Foundation. All Rights Reserved. 

     

    • Manage Email
    • Privacy Statement
    • Terms and Conditions