Beyond the Status Quo: 5 Strategic Moves to Position State and Territorial Public Health Agencies for an Uncertain Future
To help respond to this uncertain future, in late 2016, local, state, and national public health leaders convened to craft “Public Health 3.0.” Public Health 3.0 is a set of recommendations describing the upgrade needed to move public health from its current state of managing various programmatic activities and outcomes toward an intentional, strategic focus on the social determinants of health and wellness that crosscut disease “stovepipes.”9,10 The key insight of Public Health 3.0 is the realization that the most effective interventions to improve health are the result of what local, state, and federal public health organizations do themselves and their collaborative work with other agencies and organizations in health care delivery, housing, education, employment, and economic development. A core concept in Public Health 3.0 is the need for governmental public health officials to become the “chief health strategists” for their jurisdictions and embrace their leadership roles in moving upstream to address the social determinants of health and well-being.10,11
Efforts to imagine an upgraded public health system are needed and welcome. Public Health 3.0 capitalizes on the idea that the future, however uncertain, holds incredible opportunity for governmental public health but also poses significant challenges. The specific strategies and tactics needed for SHAs to upgrade from Public Health 2.0 to 3.0, however, have not been well described. Waiting for the future is a much less effective strategy than working proactively to shape it. In reviewing the perspectives, trends, and approaches that will define the governmental public agency of the future, we propose 5 key strategic moves that leaders of SHAs can take to assure optimal health for all. Despite new investments in health care delivery that incentivize payers and providers to promote population health, we posit that SHAs are the true “accountable care organizations” in their jurisdictions and the natural leaders to convene and align governmental and nongovernmental assets toward achieving both the Institute for Healthcare Improvement's “triple aim” of health care and ASTHO's triple aim of health equity.