Summary of the Public Health Infrastructure Critical Issue Breakout Session
Philadelphia: Regions I, II, III
October 5, 1998



Kristine Gebbie, DrPH, RN
Senior Advisor, USDHHS


Maurice Mullett, MD
Chairman of the Board Public Health Foundation,

Holmes County Health Department, Ohio

Martin Wasserman, MD, JD
Secretary, Maryland Department of Health and Mental Hygiene

Richard Klein, MPH
Chief, Data Monitoring and Analysis Branch

National Center on Health Statistics, CDC, USDHHS

Key points/thoughts/ideas:


  1. There is a need to motivate and encourage workers of Public Health Agencies at the local, state, and federal levels to think "outside the box." This requires workers to understand the "big picture," i.e., the goals and mission of the public health agency. Likewise, agencies must provide support for training and travel for continuing education to stimulate staff.
  2. A set of "core competencies" or a skill set for individuals in public health policy and programmatic positions must be developed and required for individuals in these positions.
  3. There should be a continuum of opportunities for young people to get exposed to and participate in public health projects. Starting in high school students should be encouraged to participate in community service projects exposing them to careers in public health. In college internships should be provided by public health agencies. In health professional schools, students should be required to take at least one course in public health and given the opportunity for internships in public health.


  1. It's still uncommon to distinguish public health infrastructure from programs services. We tend to explain infrastructure as it relates to program services that improve the health of the community.
  2. Guidelines for funding are not specific for public health infrastructure and the need for entrepreneurship is important for generating new revenues.

Systems and Linkages

  1. Community involvement is needed--locally driven approaches by all stakeholders.
  2. Efficient and useful performance measurements of public health activities within the infrastructure.
  3. More flexibility needed in public health funding, moving away from categorical funding and towards health needs assessment at the local level.
  4. Uniform integrated data systems, easier to use and fewer reporting requirements.
  5. Workforce development initiatives are needed--concerns over losing Healthy People 2010 workforce objectives for lack of data systems.

Data Systems

  1. We need to consider partners and audiences, and suppliers and users (i.e. 501C3, hospitals, nonprofits, physicians, coalitions, legislatures) when developing data systems. This can be facilitated by case studies which showcase the elements of successful data partnerships.
  2. Need to assess the capacity/infrastructure for the collection, analyses and dissemination of information via electronic systems (i.e. GIS). This can be accomplished through grants (i.e. INPHO, EPO, NLM). Also, need to establish standards of reporting; begin w/leading health indicators.

Philadelphia Transcripts and Summaries