ASTHO President Nirav D. Shah Looks Ahead to 2022

December 30, 2021 | Nirav Shah

Silver telescope mounted in front of open waterIn a year that has been equal parts hopeful, challenging, and historic, the public health workforce has dug deeper and been stretched further than ever to meet the needs of our communities. Unprecedented times have demanded an unprecedented response, and our workforce has continued to rise to the occasion.

Yet, as we head into the third year of the COVID-19 pandemic, once-lofty phrases like “unprecedented times” now feel strangely and wholly precedented. We now speak so frequently of our “uncertain future” that this uncertainty has itself become a given.

Amid so much uncertainty, it might feel naïve to make any claims about what the future holds. But it is in these moments that it becomes more important than ever to have beacons to guide us and give us hope.

As we look ahead to 2022, here are four priorities that must steer the public health course in the year to come.

1. Address the growing challenge to public health expertise.

As public health gained a greater share of the global spotlight, it has become the target for widespread criticism from policymakers and the public.

Public health’s legal authority to mitigate infectious disease outbreaks has come under fire in many jurisdictions and, in some cases, been significantly rolled back. Meanwhile, we are contending with a wildfire-like spread of mis- and dis-information that continues to erode the public’s trust in our work. These efforts to muddy the waters of public health authority have reduced community-level confidence in public health and undermined health officials’ ability to lead.

In the click-driven world of social media, the nuances of public health work are sometimes made deceptively one-dimensional by salacious headlines and tweets. Meanwhile, health officials who have courageously stepped into the spotlight to advocate for the public’s health have faced unprecedented backlash, and at times even death threats.

As we look to next year, public health leaders must make a concerted effort to build meaningful and enduring relationships with communities. We must identify and collaborate with trusted partners and clearly communicate our wins to the public.

2. Make long-term investments in a reformed public health system.

We have said it time and time again, but it bears repeating: There is a critical and chronically unmet need to make sustained, long-term investments in the future of public health.

Our data collection and data sharing systems are long outdated. Our skilled public health workforce—the lifeblood of public health—is too small, and not equipped to adequately address the demands that public health makes of it.

When an emergency strikes, the funding spikes, ushering in yet another era of feast or famine funding for public health. After an emergency abates, the funding dries up and we shutter programs, furlough staff, and move on. This is not the way to build a strong public health system.

In the new year, it is our hope that federal, state, and territorial governments will support innovative programs, strategies, and flexible funding to provide a sustained investment in public health. Our call for investment and reform must be loud and clear--and it must reverberate for years to come.

3. Continue to expand work on health equity.

Health equity remains a core piece to the public health mission. In April, ASTHO took a major step toward advancing our equal health mission by approving a policy statement acknowledging structural racism as a fundamental cause of heath disparities, and recognizing the role public health agencies can play in eliminating racism.

And in June, ASTHO partnered with Lead for America to launch the Public Health Equity Corps, an equity-driven program for young leaders to help bolster our nation’s public health infrastructure and build healthy and resilient communities.

These vital steps in the direction of achieving health equity are just that: steps. We must ensure that these actions are not merely symbolic gestures, and we must work each day to recognize and dismantle the structural discrimination at play in our communities.

4. Continue supporting state and territorial health officials—both in and out of times of crisis.

When ASTHO was founded in March of 1942, its mission was simple: to support state and territorial health officials in the mission-critical task of protecting population health. Almost 80 years later, ASTHO’s mission remains unchanged. ASTHO continues to support and stand by health officials every step of the way.

When it’s at its best, public health is a collaborative and inclusive space. What we have accomplished in public health over the last 80 years, we have accomplished precisely because we accomplished it together—and we look forward to carrying this spirit of together with us into the new year.