The federal government ended the COVID-19 public health emergency in May but this decision won’t change how we are currently living our post-pandemic lives. Instead, it should give us a moment to pause. COVID-19 is here to stay with new variants still emerging as we speak. To date, we’ve lost nearly 1.13 million Americans to COVID, and 1 in 5 people who have had COVID are suffering from long COVID symptoms. We discovered during this difficult time that our healthcare infrastructure was not prepared for the catastrophic effect of the novel coronavirus – but it’s revealed more than that. We sadly learned that those who are older, live in disadvantaged neighborhoods, have less education, and work within certain conditions are more likely to become infected with COVID-19. The evidence is clear: Black, Indigenous, Latino, and other people of color have the highest rates of COVID-19 related death.
As a public health researcher and leader in higher education who has spent the last 30 years defining and intervening on social determinants of health, I believe we are at a fork in the road, and we need to redraw the map toward equitable health and well-being.
The Steps We Need to Take to Redraw a Roadmap to Health Equity
1. We must acknowledge the substantial evidence in peer-reviewed literature that shows that health disparities exist and that social, environmental, and economic factors play a large role in determining one’s health. These social determinants of health are conditions in our environments where people are born, live, work, and age, that can affect a wide range of health and quality of life outcomes and risks. For example, being able to physically distance or work from home became an issue of privilege that was simply not an option for millions of Americans that lived in a high-density neighborhood and had to continue to earn a living as a frontline worker. We must begin to address these conditions and utilize interventions that target these social determinants of health associated with disease onset.
We need to get back to the basics to address the root causes of our continued public health problems or we won’t be prepared for the next pandemic – whether that’s an emerging infectious disease or the continued fallout from the high rates of chronic diseases like stroke and diabetes.
2. We need to expand our vision around health to shift the paradigm. A critical lesson learned from COVID was that we can’t move forward towards a healthier society without meaningful and sustainable relationships with our communities. For example, a community-led vaccination campaign experienced great success among American Indians and Alaska Native communities, despite justifiable mistrust in mandated vaccine systems. The reason for its success: Effective messaging built around protecting elders who are critical to preserving their culture and language. Successful community engagement brings together at-risk communities, academic health systems, government, and private partnerships. This type of community-engaged partnership builds trust, gives voice to communities, and begins a conversation to address social determinants of health.
3. We must nurture a workforce who is equipped to address future health challenges and optimize a more effective, sustainable public health infrastructure. This new public health workforce must be interdisciplinary, flexible, and understand the importance of a systems-based approach to healthcare. Meaning, a healthcare system that integrates all sectors of society (business, engineering, food, computer sciences, AI, machine learning, and more), into planning and implementation. Our future workforce must be nimble in addressing both infectious and chronic disease challenges. They must be able to define health broadly to include complex societal issues, such as gun violence and reproductive justice like maternal morbidity and mortality. Most importantly, this workforce must be able to engage with communities in building trust and working toward sustainable, community-based solutions to health issues.
The public health practitioner of the future must be ready to urge our policymakers to pass laws similar to HR 7585 “Health Equity and Accountability Act of 2022.” For at the legislative level, our elected officials will pass bills and laws that can have the greatest impact on improving equitable health outcomes.
It should be without question that we need to rebuild our public health infrastructure together and invest in the solutions that support a society where everyone has the opportunity to live their healthiest lives.