Jonathan Samet, Colorado School of Public Health, Aurora, Colorado.
Ross C. Brownson (
Health Aff (Millwood). 2024 Jun;43(6):750-758. doi: 10.1377/hlthaff.2024.00007.
The COVID-19 pandemic and other ongoing public health challenges have highlighted deficiencies in the US public health system. The United States is in a unique moment that calls for a transformation that builds on Public Health 3.0 and its focus on social determinants of health and partnerships with diverse sectors while also acknowledging how the pandemic altered the landscape for public health. Based on relevant literature, our experience, and interviews with public health leaders, we describe seven areas of focus within three broad categories to support transformational change. Contextual areas of focus include increasing accountability and addressing politicization and polarization. Topical areas of focus highlight prioritizing climate change and sharpening the focus on equity. Technical areas of focus include advancing data sciences, building the workforce, and enhancing communication capacity. A transformed public health system will depend highly on leadership, funding incentives, and both bottom-up and top-down approaches. A broad effort is needed by public health agencies, governments, and academia to accelerate the transition to a next phase for public health.
新冠疫情和其他正在发生的公共卫生挑战凸显了美国公共卫生系统的缺陷。美国正处于一个独特的时刻，需要进行变革，这一变革以公共卫生 3.0 及其对健康社会决定因素和与不同部门合作的关注为基础，同时也承认大流行如何改变了公共卫生的格局。基于相关文献、我们的经验以及对公共卫生领导人的采访，我们在三个广泛的类别中描述了七个重点关注领域，以支持变革性变革。背景重点领域包括提高问责制和解决政治化和两极化问题。专题重点领域强调优先考虑气候变化和加强公平问题。技术重点领域包括推进数据科学、建设劳动力队伍以及增强沟通能力。一个变革后的公共卫生系统将高度依赖领导力、资金激励以及自下而上和自上而下的方法。公共卫生机构、政府和学术界需要共同努力，加速向公共卫生的下一阶段过渡。
