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Public Health Infrastructure
The Health Challenge:
The public health infrastructure is responsible for protecting people's health and safety, providing credible information for better health decisions, and promoting good health through a network of partnerships. It is made up of the work force, information and data systems, and the state and local public health organizations across the country.
In the last 100 years, public health as increased life expectancy by 30 years through vaccinations, control of infectious disease, fluoridated drinking water and many other activities. Today, this infrastructure lacks the capacity to respond quickly to public health threats. Whether it is the spread of the West Nile virus into new areas of the United States, an outbreak of E.coli 0157:H7, or a bioterrorism attack involving anthrax at an airport, the public health system has struggled to keep pace with increasing demands. At the same time, budget cuts, lack of training and outmoded information systems and laboratories have created greater challenges in protecting the public's health against threats and emergencies.
In March 2001, the Centers for Disease Control and Prevention delivered to the Senate Public Health’s Infrastructure: A Status Report, which included the following findings:
The Public Health Threats and Emergencies Act of 2000, passed by Congress in November 2000, authorizes CDC and its national partners to design performance standards for state and local health departments, identify gaps in actual performance and provide federal assistance to help build core capacity. Under a new grant program, CDC will provide grants to states to develop their own assessment plan and public health infrastructure.
CDC and its national partners are focusing on three major areas of activity:
The public health infrastructure sections of the Public Health Threats and Emergencies Act authorize $99 million for development of capacities, assessment, planning and core-capacity grants. The President's budget for fiscal year 2002 includes $1 million to begin implementation of these sections. Public health organizations, such as the National Association of County and City Health Officials, are advocating for $100 million for public health infrastructure in CDC's Public Health Improvement budget line. CDC is meeting with partners and state and local public health officials to determine what would be the best use of appropriated funds.
Work force Capacity
The Public Health Training Network is a distance-based learning approach that regularly provides training to nearly one million frontline public health workers each year in the United States and around the world. The network gives these workers continuing education and training in core skills such as principles of public health, public health surveillance, informatics, management, immunization, public health in the political arena, tobacco cessation, HIV/AIDS and environmental health. The Network has classes scheduled through December 2002.
CDC is committed to providing formal training to all public health workers who oversee public health agencies. CDC also is ensuring that all public health practitioners are culturally competent and know the language of those whom they serve. One step is the launch of a Spanish-language version of CDC's website.
Information and Data Systems
The Health Alert Network is a nationwide information and communication system that serves as a platform for the distribution of health alerts and prevention guidelines, distance learning, national disease surveillance and electronic laboratory reporting, and other initiatives to strengthen state and local preparedness.
CDC has provided $19 million in grant funds to state and local health departments. By the end of 2001, every state will be funded on the Health Alert Network. CDC has helped enhance state and local health agencies in detecting, reporting and responding to infectious disease outbreaks across the country.
CDC is committed to developing a local response system for early warnings in case of a public health emergency that will:
The National Public Health Performance Standards Program has field-tested and revised its national, state and local instruments for assessing the public health system capacity to perform essential services. CDC plans to build on the work of the Performance Standards Program in developing the capacities called for under the Public Health Threats and Emergencies Act. From these capacities, state and local health departments will be able to determine their infrastructure needs and develop public health improvement plans.
The Public Health Threats and Emergencies Act of 2000 is a major step toward strengthening the public health infrastructure. CDC is playing a leadership role in implementing the Act and to ensure that every health department is prepared to address current and evolving threats to the health of the citizens it serves.
CDC Web Sites:
Other Web Resources:
National Association of County and City Health (NACCHO)
Association of State and Territorial Health Officials (ASTHO)
For more information, contact:
Office of Communication
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CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.
This page last updated May 14, 2002
United States Department of Health and Human Services