We are entering a critical period for public health and its leaders. The implementation of the Affordable Care Act will impact Public Health in a negative way. Population health issues are mainly ignored in the Act. Clinical prevention is about clinical tests for individuals. Services for seniors through Medicare will also be impacted through the transfer of monies towards other sectors of the health care system. The differentiation between what primary care does and what public health does will be muddied even more than it has in the past. The reality is that Washington politicians do not understand public health and what it does. Public Health professionals and their organizations have for the most part failed in getting the public health message understood in Washington and in our various states. There also seems to be a lack of understanding for why workforce development and the importance of lifelong training is a critical component for the health of the public. Funding for Public Health Training Centers has been cut 80% for next year. This is insane if the public health mission of health promotion and disease prevention is to be maintained. Funding for emergency preparedness and response is also being significantly affected. Health is about primary prevention and support for it is lacking. Our elected officials do not understand the lack of support for this is critical if our quality of life is to be maintained.
I was recently asked to look at leadership and its present challenges to public health. Specifically our challenges are:
In addition to the ACA, an additional challenge related to terrorist events in the United States. Public health leaders have been involved in reacting to these terrorist events and the response to these events. Preparedness activities have become a major activity of state and local health departments since 2001. Leaders have been engaged in specific response activities, the creation of public health plans for all hazard events, conduct of disaster exercises, and the building of partnerships to address community events both natural and man-made. With the Boston marathon disaster, it is clear that these preparedness activities must continue in spite of major funding cuts.
Not much seems to get the support of Congress these days if additional funding is needed. Washington gridlock is an important challenge. There seems to be a major disregard of the concerns of the public. Politics reign and Congress people seem to be bought by major lobbyists to the detriment of concerns of their constituents. Public health leaders seem to advocate for issues without any interest by our elected officials. It is only a crisis event that Congress responds to, but their memories are short and nothing gets done. Our elected officials do not show real leadership.
Even climate change has become political with politicians arguing that climate change is not real. This is in spite of the fact that there are clear indications of severe weather changes occurring. Our future is at stake. Maybe we have to remember what happened to the dinosaurs.
Leaders need to be concerned about the issues of the World and how these issues impact our work and our lives. Just because Congress cuts funding related to public health does not mean that our public health issues go away. We leaders still have to fight for the health of the public. We need to demonstrate that our votes do make a difference.
Rowitz On Leadership 