Chelsea Dade
Well, we made it (sort of). Now that there is a new administration in line, we can expect to get back to a bit of normalcy. Who knew that our public health system could be turned upside down in less than a year?
For the most part, we all knew that the CDC was a government-run entity. What we did not expect was to witness an administration use their executive control in a manner that hurt the public’s health, rather than protect it.
We are nearing a vaccine but let us never forget the way that COVID-19 challenged our ideas about the strength of the American public health system. The current administration has shown us that the federal government has much more power than we as health professionals like to admit. Whether you are a part of a well-funded state health system or not, work in communications or public policy, the delays in guidance from the CDC, misinformation, and inadequate supplies of protective equipment were consequences that were primarily out of the public health industry’s hands. And that was a scary thing to witness.
Thankfully, we are beginning to see the other side of the tunnel. But let’s look at a few considerations for the field of public health going forward:
1) How will we disseminate the vaccine to priority communities? By now you’ve probably seen the news from Moderna, Pfizer, Oxford, and other private-sector manufacturers that are getting closer to developing an effective COVID-19 vaccine. Some of these trials have even managed to test the efficacy of a vaccine on diverse groups of people. But has anyone thought about how the government and health systems will get people to take the vaccine? Let’s assume the vaccine is paid for by employer-based insurance, the ACA, and Medicaid or Medicare. Now the vaccine is “accessible.” The next step is getting people to take the vaccine. Let’s not forget the horrific experiences African Americans have had with medical experimentation. Access is one thing, trust is another. Government officials are going to need the insight of people in public health, particularly those who are Black and people of color, and also have a background in health communication and community engagement if we want to achieve maximum vaccine distribution in all communities.
2) The idea that public health can operate in a void above politics cannot persist. We have seen first-hand how deeply entrenched politics can be in public health without provocation. Any industry related to health and wellness, from healthcare to group fitness, must come to terms with the fact that politics affect all aspects of the work we do to keep people healthy. Some people even refer to the commonly quoted “social determinants of health” as the “political determinants of health.” We look at race, gender, sexual identity, and religion, and the way that these markers determine who is deemed worthy of health is indeed political.
3) Public health and government need to work as one! I know some of you are probably rolling your eyes at this last one. But it’s true! People with health backgrounds must be in positions to relay their expertise in public service for the greater good. Who better to advocate for more public health funding that the people who know public health best? We need more leaders with backgrounds in public health, like Rep. Elect Cori Bush and Rep. Lauren Underwood, along with other voices to amplify the message of health equity in the halls of government.
Public health is a field where everyone should be able to find their own space. We can’t forget that this as we attempt to pull off the most historic public health intervention in our time to end COVID-19. It will take all of us.