Ross C. Brownson is with the Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO. Ross C. Brownson and Graham A. Colditz are with the Department of Surgery and Alvin J. Siteman Cancer Center, School of Medicine, Washington University in St. Louis. Thomas A. Burke is with the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Jonathan M. Samet is with the Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora.
Am J Public Health. 2020 Nov;110(11):1605-1610. doi: 10.2105/AJPH.2020.305861. Epub 2020 Aug 20.
The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for society, affecting those already subject to unacceptable health inequalities and resulting in vast economic impacts. The pandemic reminds everyone of the value and necessity of public health.In the context of an era that will be shaped by COVID-19, we outline the coming series of challenges and transitions in public health and the needed actions over the next 5 years to reinvent our public health systems. Multiple limitations in current US and global public health systems have been uncovered by the pandemic, including insufficient preparedness and surveillance capabilities complicated by long-standing and worsening health inequalities and the rapid spread of misinformation that needs to be countered. We foresee 3 phases for public health over the next 5 years: (1) reactive crisis management, (2) efforts to maintain initial gains, and (3) efforts to sustain and enhance progress.A reinvented public health system will depend highly on leadership and political will, rethinking how we categorize and address population-level risk, employing 21st-century data sciences, and applying new communication skills.
新型冠状病毒肺炎(COVID-19)大流行是对社会的空前挑战,影响到那些已经面临不可接受的健康不平等的人,并导致巨大的经济影响。这场大流行提醒人们重视和需要公共卫生。在 COVID-19 时代的背景下,我们概述了未来 5 年公共卫生领域即将面临的挑战和转变,以及需要采取的行动来重塑我们的公共卫生系统。这场大流行揭示了当前美国和全球公共卫生系统存在的多种局限性,包括准备和监测能力不足,再加上长期存在且日益恶化的健康不平等,以及需要加以应对的快速传播的错误信息。我们预计未来 5 年公共卫生将经历 3 个阶段:(1)应对危机的反应式管理,(2)维持初始成果的努力,以及(3)维持和加强进展的努力。一个重塑的公共卫生系统将高度依赖领导力和政治意愿,重新思考我们如何对人群层面的风险进行分类和处理,运用 21 世纪的数据科学,并应用新的沟通技巧。