Strengthening and Modernizing the Public Health System

September 16, 2022

The COVID-19 pandemic exposed the pre-existing weaknesses of the U.S. public health system including areas such as communication, organization, and entrenched health disparities that continue to drive massive health inequities in various communities. To strengthen routine public health practice and better prepare for future emergencies, it is important to clarify and strengthen operational roles of the federal government, address funding challenges, optimize data capabilities, and restore public trust. Partnering with states and localities will be pivotal in addressing these issues as well. The goals of this briefing were to: 1) discuss what a successful and effective public health system looks like; 2) illustrate how the U.S. can better meet every day public health challenges; and 3) explore how an efficient and effective public health system can more effectively anticipate and respond to public health emergencies.

Key Takeaways:

  1. The COVID-19 pandemic exposed long-standing weaknesses in our public health system that hinder our ability to respond in emergency situations, prepare for future crises, and conduct day-to-day public health functions.
  2. Stable, de-siloed funding is necessary to implement a robust public health system, both in times of crisis and when crisis subsides.
  3. Increased workforce diversity, training, and retention are critical to creating an effective and sustainable infrastructure.
  4. The current data infrastructure is antiquated, and lacks the capacity needed to address public needs and inequities. Data modernization is instrumental in integrating systems of care and rebuilding trust in public health.
  5. Cross-sector, community-based partnerships are necessary to bridge the gap between communities and the broader public health system.
  6. Collective action is required to sustain disease prevention measures and eradicate the barriers that perpetuate inequities.


  • Andrew Bazemore, M.D., MPH, Senior Vice President of Research and Policy, American Board of Family Medicine
  • Joneigh Khaldun, M.D., MPH, FACEP, Vice President and Chief Health Equity Officer, CVS Health
  • Howard Koh, M.D., MPH, Harvey V. Fineberg Professor of the Practice of Public Health Leadership, Department of Health Policy and Management, Harvard T. H. Chan School of Public Health
  • Erika Martin, Ph.D., MPH, Professor of Public Administration & Policy, University at Albany, SUNY
  • Denise Smith, MBA, CHW, P.N., Executive Director, National Association of Community Health Workers
  • Rachel Nuzum, MPH, Vice President, Federal and State Health Policy, Commonwealth Fund (moderator)

Presentation: Strengthening and Modernizing the Public Health System

Event Resources

Key Resources

“Two Red States Show How the Nation’s Public Health System Can Be Fixed.” Sparer, M., Brown, L. The Boston Globe. September 8, 2022. Available here.

“Building a National Public Health System in the United States.” Hamburg, M., Cohen, M., DeSalvo, K., et al. The New England Journal of Medicine. August 4, 2022. Available here.

“Is it Time for a National Public Health System?” Wen, L. The Washington Post. July 5, 2022. Available here.

“Meeting America’s Public Health Challenge: Recommendations for Building a National Public Health System that Addresses Ongoing and Future Health Crises, Advances Equity, and Earns Trust.” Hamburg, M., Cohen, M., DeSalvo, K., et al. The Commonwealth Fund. June 21, 2022. Available here.

“Citing a Disastrous Pandemic Response, An Expert Panel Calls for an Overhaul of the U.S. Public Health System.” Stolberg, S. The New York Times. Available here.

“Reimagining Public Health Infrastructure and the Health Workforce for the 21st Century.” Brand, N., Pope, S., Bednash, G., et al. Health Resources & Services Administration (HRSA). October 2021. Available here.

Additional Resources

“Creating a Modern Public Health System.” Executives for Health Innovation. 2022. Available here.

“A Strong Public Health System Depends on Making the Invisible Visible.” Seervai, S. The Commonwealth Fund. June 3, 2022. Available here.

“The Modernization of the Public Health System.” Stinson, C., Parekh, A. CDC Foundation. January 2022. Available here.

“The Public’s Perspective on the United States Public Health System.” Harvard T.H. Chan School of Public Health and Robert Wood Johnson Foundation. May 13, 2021. Available here.

“Positioning America’s Public Health System for the Next Pandemic.” Armooh, T., Barton, T., Burgos, A., et al. Bipartisan Policy Center. June 2021. Available here.

“Strengthening Our Public Health Infrastructure: COVID-19 Lessons.” Badaracco, C., Bai, W., Burnett, B. et al. Avalere. February 19, 2021. Available here.

“Building Back Trust in Science and America’s Public Health Agencies.” Armooh, T., Chen, E. Bipartisan Policy Center. January 11, 2021. Available here.

“The COVID-19 Pandemic – Insurer Insights Into Challenges, Implications, and Lessons Learned.” Lucia, K., Blumberg, L., Curran, E. Robert Wood Johnson Foundation and Urban Institute. June 2020. Available here.