The Case for a Public Health Infrastructure Fund

U.S. public health protections should be as reliable as our nation’s highways, argue two respected public health professionals in an opinion piece published in Roll Call, a non-partisan publication focused on the people and politics of the U.S government. They also make the case for what they call “a public health system with foundational capabilities”in a white paper published by the Public Health Leadership Forum with funding from the Robert Wood Johnson Foundation, and they discussed how to finance the infrastructure at an event held at the Bipartisan Policy Center on December 11.

“Our nation’s chronic public health issues, like heart disease, cancer and HIV/AIDS… continue to take a toll on the length and quality of life for people in the United States. This also takes a toll on the health and vitality of our communities and comes at great cost to our federal and state health care budgets,” say Karen DeSalvo, MD, a professor of medicine and population health at the University of Texas at Austin’s Dell Medical School (and former HHS acting assistant secretary for health) and Jeffrey Levi, PhD, a professor of health policy and management at the George Washington University’s Milken Institute School of Public Health.

Levi and DeSalvo were on the panel of experts brought together by the Public Health Leadership Forum to envision on how the nation might commit to building our public health infrastructure. The paper’s definition of the foundational public health infrastructure includes:

  • the ability to track the health of a community through data, case findings, and lab tests; the capacity to respond to emergencies of all kinds;
  • the experience to translate public health science into appropriate policy and regulation;
  • the adeptness to communicate effectively with the public with timely, science-based information;
  • and the power to harness and align community resources and actors to advance the health of the entire community.

Informed by a national study conducted by the University of Kentucky, the panel who authored the white paper found that supporting foundational public health capabilities across the country would cost an estimated $9.5 billion a year. “That sounds like a lot of money, but it comes to only $32 per person per year. Compare that to the estimated $11,193 per person we spend on health care, and it is a great return on investment,” DeSalvo and Levi say in their opinion piece.

Current spending on foundational capabilities is $19 per person across all levels of government.  The paper calls for creating a new $4.5 billion fund that would close this gap in spending.

“We hope Congress will also see investment in a Public Health Infrastructure Fund as a critical step to assuring all people in America have the public health protection they should expect and deserve,” they conclude.

“Public Health Should Be as Reliable as Our Highways” can be accessed here.