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Rethinking the future of public health

Recent health emergencies exposed significant gaps in the US state and local public health infrastructure.


In brief
  • State and local public health departments have the unique opportunity to assess lessons learned and capabilities built to improve go-forward operating models.
  • Many states have identified operating model redesign as a priority improvement area for the future of public health.
  • State and local leaders should consider four guiding principles to rethink the future of public health operating models.

An operating model represents the organization’s processes, technologies, capabilities and partnerships that translate its mission, vision and strategy into value for its constituents. The COVID-19 pandemic and other recent public health emergencies exposed significant gaps in US state and local public health operating models. As demand for public health services surged during the onset of the pandemic in 2020, most state public health agencies and local health departments were predictably overwhelmed. To address capacity and capability gaps, the federal government granted an unprecedented nearly $300 billion to public health from 2020 to 2027.¹

Rethinking the future of public health


The result was a massive scale-up of public health operations and mobilization of public-private partnerships that catalyzed innovation, built new capabilities, and temporarily expanded capacity. We learned about the resilience and fortitude of public health professionals and community health workers. We also learned about the underlying challenges embedded in public health operating models and organization structures.

 

To better understand the need to rethink the future of public health, Ernst & Young LLP (EY US) conducted a survey of 301 public health officials across the United States. The survey found more than 80% highlighted their public health operating model as a weakness during the COVID-19 pandemic.² Further, these public health leaders emphasized the critical need for increased public-private collaboration and modernized approaches to improving health equity.

 

During the pandemic surge, we worked with several state and local public health departments to address operating model gaps and operationalize public-private partnerships for equitable access to vaccinations, testing and treatments. This trend toward increased collaboration has accelerated as many public health departments are more actively collaborating with health systems, managed care organizations (MCOs), and community-based organizations (CBOs) to address health equity gaps and social determinants of health (SDOH) for the populations and communities they mutually serve.³

 

Taken together, the findings from the EY US public health survey and insights from recent market trends highlight the imperative for state and local public health leaders to rethink the future of their operating models and organization structures.



Summary 

Now is the time to rethink the future of public health. The critical next steps involve aligning the organization on purpose, designing end-to-end constituent experiences, developing a workforce capability matrix to assess gaps and defining future operating structures to improve the efficiency, effectiveness and impact of public health organizations. This simple, four-step approach provides a blueprint for public health leaders to define an actionable strategic roadmap of initiatives and investments required to build the future of public health infrastructure and workforce capabilities.

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