Emerging Issues

Because of the broad-based origins and intrinsically cross-cutting nature of the public health infrastructure, issues and limitations are wide ranging. Some examples include the following:

• A greater need for adequate and continuing training in public health core competencies for State and local health departments.
• State-level information technology to train the public health workforce in the field.
• Effective communication between State health departments to disseminate and receive information at the Federal and local levels.
• Enhancement of State and local health department links to the U.S. Department of Homeland Security and other agencies involved in community-based and national disaster response.
• Ability of State and local health care systems to rapidly shift the allocation of their resources from chronic diseases to emergency situations like bioterrorism and infectious disease outbreak.

The events of the first half of the decade have given rise to new State-led initiatives in the areas of enhanced communications and coordinated information systems. States have begun to pool resources for information systems that can ensure the timely exchange of critical data. Nearly half of the States have collaborated on standardized laboratory information system specifications.¹⁸ Also, nearly half of the States have financed a nationwide learning management system known as the Training Finder Real-time Affiliate Integrated Network.¹⁹ A catalog of information and resources that can assist public health leaders in tracking the development and activities related to information systems is available at the Public Health Infrastructure Resource Center.²⁰

State and local health departments have purchased updated hardware and information and communication systems for surveillance and other purposes with the Federal bioterrorism dollars. However, data sharing among these systems overall remains limited.²¹

Although bioterrorism and emergency preparedness are relatively new issues that the public health system must face, the issues of infectious disease outbreak and natural disasters have always been present. The urgent and frequently unexpected nature of these events places stress on a public health system that has increasingly focused on responding to the effects of increasing chronic disease. Achieving gains in the Nation's workforce, laboratory, surveillance, information systems, research, legal, and other public health system capacities are central to allowing for effective response to these stresses. Such gains need to cover the wide spectrum of issues that burden the Nation's public health infrastructure. The future success of the public health system will depend on the ability to change to meet new threats to the public's health.

<< Previous—Opportunities and Challenges  |  Table of Contents  |  Next—Progress Quotient Chart >>