Strengthening New York's Public Health System for the 21st Century



The current economic challenges facing governments throughout the nation makes the public health infrastructure assessment all the more timely. Continuous quality improvement requires periodic evaluation in order to identify gaps and provide appropriate solutions. The public health system must be responsive to new thinking, emerging issues, innovative solutions and smarter investments in its infrastructure. Leaders must continuously appraise and prioritize the opportunities and the threats to the population's health. Community partners must join in efforts to safeguard the population's safety and health beginning at the local level. All the assets of the infrastructure must demonstrate proficiency, competence and emergency readiness if the full public health system is to function well in ordinary and extraordinary times.

The public health system must be strengthened to meet today's emerging threats while still maintaining the traditional essential core services at community and state levels. The tensions existing in the system as a whole due to expanding challenges must be resolved. The Institute of Medicine has correctly identified the current dilemma as a potential conflict for society. They have observed that "… health is part individual good served by medicine, part public health activities. Instead of complementary and collaborating systems, the two disciplines, their institutional cultures, their agencies and organizations, and the public's opinion of them, have often been deeply divergent, and the individual focus of one and the population focus of the other have become further reinforced and polarized."35 Funding when weighed against documented needs and new priorities must be studied, quantified, and changed to sustain investments in public health.

Failure to renew the public health infrastructure to more effectively meet tomorrow's priorities will put communities at greater risk in a world where risks to good health have already risen to new levels.

35 Ibid. p. 23