Alice T. Chen (
Denise O. Smith, National Association of Community Health Workers, Boston, Massachusetts.
Health Aff (Millwood). 2024 Jun;43(6):805-812. doi: 10.1377/hlthaff.2024.00033.
The COVID-19 pandemic demonstrated a need to strengthen the US public health system by shifting toward much greater community engagement and leadership. In November and December 2023, we conducted separate online surveys of community-based organizations and large metropolitan health departments to identify barriers and opportunities for building a public health system with strong community partnerships. Identified barriers included mistrust, siloed health departments with structural challenges in funding community-based organizations, and insufficient shared decision making. The surveys helped inform our six policy recommendations: establish state and local community councils to formalize the roles of community-based organizations in public health decision making; dedicate funding to these organizations; offer funding that is not limited to a specific disease or condition; simplify procurement and reporting processes directed to community-based organizations; create a training and technical assistance program for these organizations; and increase public health worker diversity, including sustainable funding for community health workers.
新冠疫情大流行表明，美国需要通过加强社区参与和领导力来加强公共卫生系统。2023 年 11 月和 12 月，我们对社区组织和大型都市卫生部门进行了两次独立的在线调查，以确定建立一个具有强大社区伙伴关系的公共卫生系统的障碍和机会。确定的障碍包括不信任、卫生部门各自为政，在为社区组织提供资金方面存在结构性挑战，以及决策过程中缺乏充分的共享。这些调查为我们的六项政策建议提供了信息：建立州和地方社区委员会，将社区组织在公共卫生决策中的作用正式化；为这些组织提供专门资金；提供不限于特定疾病或病症的资金；简化针对社区组织的采购和报告流程；为这些组织创建一个培训和技术援助计划；并增加公共卫生工作者的多样性，包括为社区卫生工作者提供可持续的资金。
