Building a More Equitable Public Health System

Over the past year and a half, our country’s public health system faced perhaps the greatest challenge of our lifetime. In a true fight-or-flight moment for our nation, decision-makers quickly mobilized to pivot, readjust and unite in the fight against COVID. In turn, stakeholders from all areas of industry, academia and government — including those with competing interests — collaborated to ease regulations, kickstart innovation and develop groundbreaking treatments and technologies. Unfortunately, the pandemic also amplified the deep-rooted disparities that have long been an inherent part of our nation’s healthcare system.

In Order to Make Progress, We Must First Admit the Problem

The pandemic shed light on the importance of Social Determinants of Health (SDoH) – the places where we live, work, learn, play and age – in our overall wellbeing, and how these determinants disproportionately affect low-income and BIPOC communities. According to data from the Centers for Disease Control and Prevention, African Americans and the Latinx community in the U.S are three times more likely to contract COVID-19 than White residents and nearly twice as likely to die from it. While COVID has increased the urgency around these issues, they’re far from a new phenomenon. As a case in point, a 2003 study from the Institute of Medicine found that members of minority groups are less likely than White individuals to receive preventative care. Of minority members who do receive preventative care, it is often of a lower-quality and leads to worse outcomes for many conditions. Factors such as housing inequality, systemic racism, and other socioeconomic inequities have reinforced this reality.

As the fight against COVID continues amid new variants, there’s an opportunity to address key issues prevalent in our health system in order to bring about a more equitable future, but we must first recognize and understand the underlying causes.

Equalizing the Technological Playing Field

Access to internet and modern technology quickly became a necessity for millions of Americans’ access to healthcare. Yet for the millions of Americans without access to these tools, essential healthcare services were no longer within reach. Amongst those living in rural America, for example, only 43% of low-income adults can access the internet.

With President Biden’s plan to expand broadband access, there is progress being made towards achieving healthcare equity for rural and underserved populations. Additionally, investments need to be made in the technology federal and state governments rely on to monitor and manage public health. This includes updating the systems used in health programs such as infectious disease monitoring, cancer and asthma prevention, and drinking water quality monitoring to insure agile, interoperable, and secure systems that can provide data in real time.  

Accelerate the Shift Toward Data-Driven, Whole-Person Healthcare

The concept of treating the whole person has been discussed at length, but the pandemic has underscored the need to incorporate behavioral and social determinants of health into standard healthcare practice. Profound racial, ethnic and socioeconomic disparities in the impact of COVID-19, combined with an emerging mental health crisis, has made it impossible to ignore these crucial components of health.

As an industry, we know what we need to do to advance whole-person care — overcome barriers to data sharing and cross-sector collaboration, engage consumers in their health and wellbeing, and advocate for policies that support the viability of integrated care models. Now is the time to act.

Improving Immunization Record Tracking

Vaccines and immunization records have undoubtedly been a hot topic of conversation during the pandemic, bringing to light the fact that there are currently no national certification standards on how records should be handled. In fact, it is optional in many states for pharmacies, providers and other entities administering vaccines to report immunization information to their respective registries, resulting in a patchwork of data and no single source of truth on this critical aspect of public health.  

The pandemic has made clear the need to develop the necessary infrastructure for standardized immunization records, and that reporting this information should be mandatory regardless of where the immunization is administered. As we continue to vaccinate the population against COVID-19, we have an opportunity to modernize our immunization registries in preparation for future pandemics, while better monitoring routine immunizations against vaccine-preventable illnesses.

Enabling Cross-Sector Partnerships

From telehealth solutions to rapid vaccine development, the COVID-19 pandemic has been a model of successful partnerships and coordinated response across state and party lines.

This cooperation between federal, state and private sectors should continue after the pandemic. Breaking down silos between agencies, regions and jurisdictions will help ensure preparedness and resource allocation in the event of any future national or global crises. Having efficient and secure mechanisms in place for government and healthcare entities to exchange information is vital to general disease prevention and overall population health.

Long Term Investments in the Health System

While a pandemic will (hopefully) remain a once-in-a-century event, smaller epidemics happen far more frequently, such as Ebola, H1N1, Avian Flu, and others. Additionally, emergency preparedness initiatives put in place for epidemic/pandemic prevention and response will also help with rapid response to natural disasters such as hurricanes, floods, etc. 

While previous epidemics, like H1N1, spurred funding and investment initiatives, most were short-lived and funding dried up when they were no longer top of mind. It is critically important that we do not lose sight of the benefits of emergency preparedness initiatives and that funding and research remains ongoing, even after COVID-19 is in our rearview mirror. Long-term, sustained investments in our public health system will ensure ongoing preparedness and help mitigate any future large-scale crises, while also enabling a more equitable experience for all Americans.