A Transformed Health System in the 21st Century Position Statement

Health and well-being for all people in America is vital to current and future competitiveness and global security for the United States. To that end, the United States must become the healthiest nation in a healthier world. We envision a 21^st century health system that results in optimal health for all and a longer life span and healthier quality of life for succeeding generations. Such a system must be sustainable and adequately resourced, provide universal access to quality, patient-centered care that is delivered in a timely and cost-effective manner, promotes health, effectively manages illness, and focuses on outcomes.  The health system of the future must prioritize prevention, support healthy environments and lifestyles, and provide, at a minimum, public health and preventive and primary care for every person, including for the disabled and underprivileged.  Inequities in health status must be eliminated, evidence must be used to inform practices and policies and people, and communities must be protected from existing and emerging health threats.

A transformed U.S. health system must be:

• Oriented toward health, rather than sickness, and able to address the known determinants of health – environmental, social, behavioral, and medical.
• Comprehensive and capable of fostering health promotion and disease prevention at all levels, including individual, family, community, and country.
• An amalgamation of the resources and knowledge of public health, health care, and all public and private sector entities that influence health outcomes at the community, state, and national levels.
• Inclusive of the unique expertise of partners that together influence population health.  These partners include education, housing, criminal justice, environmental protection, and agricultural systems, as well as those not traditionally associated with health, such as transportation, industry, and energy, to assure that every person in America is served by a robust public health system.
• Capable of continuously measuring and improving the health of the public while being fully accountable and transparent.
• Built on key health system capabilities, including a standardized, integrated, individual, and public health information system; a sufficient and appropriate mix of health professionals; and flexible, sustainable financing.

A transformed U.S. health system demands new and different commitments and investments from both government and the private sector. The United States must establish health as the priority, rather than responding to acute and chronic illness. It is imperative we begin now by creating a shared vision and taking steps to generate a United States that is the healthiest nation in a healthier world.

The first steps include:

• An ongoing commitment from policymakers to invest in health promotion and protection as the basis of health system transformation.
• Supporting public health’s capability to accomplish its mission with flexible, sustainable financial resources.
• Supporting the national commitment to create health equity.
• Supporting an adequate number, specialty mix, diversity, and distribution of public health and health care workers to reflect the unique needs of diverse communities, through the development of policies, and sustainable and flexible financing.
• Establishing “health in all policies” by evaluating and addressing the health impact of all policies across all governmental and private agencies and all sectors of the economy.
• Developing policies that promote health and well-being in the built-environment, including childcare centers, schools, workplaces, communities, and homes.
• Developing and implementing policies and empowering people to make it easier for individuals to make healthy choices for nutrition and physical activity where they live, learn, work, and play.
• Ensuring the use of evidence-based public health to inform multilevel policies aimed toward improving health.
• Designing electronic record exchanges to support the two-way exchange of public health and clinical data and educating the public about the use, value, and purpose of personal and family health records.
• Creating communities that promote health by encouraging collaboration among medical care providers, the public health system, and traditional and nontraditional partners in the public and private sectors with patients as the focus.
• Create healthy work environments and communities that maximize opportunities for improved health and minimize environment-related health risks, including communicable diseases, accidents and injuries, stress, exposure to toxic substances, and dangerous consumer products and services.
• Fostering a culture of preparedness that includes the system capacity to prevent, mitigate, or recover from threats to the health, safety, and security of our communities.
• Responding to the universal public need and demand for benefitting from public health and access to comprehensive health care that:
  • Emphasizes prevention and helps people use existing health services and systems effectively.
  • Provides incentives for healthy behavior.
  • Covers all immunizations recommended by the Advisory Committee on Immunization Practices and all clinical preventive services and screenings recommended by the U.S. Preventive Health Services Taskforce.
  • Promotes systems that support chronic disease management and the establishment of “medical homes.”
  • Links the individual and healthcare provider to resources in the community that support improved quality of life.
  • Ensures quality of care for all consumers regardless of race, ethnicity, income, language ability, education, sexual orientation, gender identity, or age.
  • Supports a system that gives people the greatest opportunity to make a healthy choice and to live healthy lives.
  • Promote systems that support humane and quality end-of-life care.
   

APPROVAL HISTORY:

ASTHO Position Statements relate to specific issues that are time sensitive, narrowly defined, or reflect further development or interpretation of ASTHO policy. Statements are developed and reviewed by appropriate Policy Committees and approved by the ASTHO Executive Committee. Position Statements are not voted on by the full ASTHO membership.

Access Policy Committee Approval: April 2012.

Board of Directors Review Approval: June 2012.

Policy Expires: June 2015