What Is Public Health 3.0?
If you’ve recently discovered Public Health 3.0 and you are interested in learning more about it, you’re not alone. While there are tons of health departments all over the country already implementing the goals of Public Health 3.0, there are still many health agencies who are unsure where to begin or may have never even run into this term. For this article, we shall go through the basics of Public Health 3.0 and tell you everything you need to know about this recent development.
What is Public Health 3.0?
The term Public Health 3.0 was originally coined by Karen B. Desalvo, MD, MPH, MSs Acting Assistant Secretary for the US Department of Health and Human Services (HHS) back in 2016. During that very same year, the Office of the Assistant Secretary for Health (OASH) released a white paper that was titled, Public Health 3.0: A Call to Action to Create a 21st Century Public Health Infrastructure which really defines the entire momentum of Public Health 3.0.
Public Health 3.0 is a term that goes on to describe a progression or modernization of the public health system and goals. Public Health 3.0 isn't an entirely new concept, in fact, the whitepaper released in 2016 mentions, “Public Health 3.0 exemplifies the transformative success stories that many pioneering communities across the country have already accomplished. The challenge now is to institutionalize these efforts and replicate these triumphs across all communities for all people. Our collaborative action must ensure, for the first time in history, that every person in America has a truly equal opportunity to enjoy a long and healthy life.”
Why is this happening now?
The Office of Disease Prevention of Health Promotion (ODPHP) were the ones who answered this question most have had in on their mind. They’ve stated that they often hear about someone's zip code is more important to someone's health instead of their genetic code, and public health not only has to become a part of that shift in thinking, but they also have to be prepared to pave the way for it. It’s time for people to reevaluate how they can turn those indicators and social determinants around and take the lead in making communities much more healthier.
Public Health 3.0 is more incredibly defined focus on addressing every single factor that is associated with a person’s overall health, from the social determinants of health or the conditions in which people are born, live, work and age.
Where did it come from?
The Entire history behind public health from the late 19th century to the present time can be simply broken down from the Centers for Disease Control and Prevention (CDC) into three periods of public health advancement which have been labeled as, Public Health 1.0, Public Health 2.0, and Public Health 3.0.
Public Health 1.0
As stated by the CDC, during the 19th century through a good percentage of the 20th century, public health was becoming increasingly essential part of governmental function with specialized federal, state, local, and tribal public health agencies.”
During this time frame, public health was capable of:
- Develop systematized sanitation
- Improve food and water safety
- Expand understanding of diseases through advancements in science
- Develop vaccines and antibiotics to help with prevention and treatment
- Expand capability in epidemiology and laboratory science
Public Health 2.0
Public Health 2.0 was initiated during the second half of the 20th century and was immensely transformed by the 1988 IOM report by The Future of Public Health. The IOM Committee decided that public health had become way too focused on providing clinical care and wasn’t preparing itself to handle a new era marked by the increase of chronic diseases such as the HIV/AIDs epidemic.
Furthermore, as of the late part of the century, the capacity and effectiveness of public health agencies varied tremendously all over the country, with a minimal amount of consensus about what should be expected from a public health agency.
This resulted in:
- The IOM Committee defined a core set of functions for public health: assessment, policy development, and assurance.
- Public health became more focused on improving health through prevention, management, and treatment of diseases
- Performance standards were established for public health agencies, which has matured into today’s accreditation standards
- Public health agencies became increasingly professionalized
Public Health 3.0
Regardless of the changes made by the introduction of Public Health 2.0, there are still challenges that are occurring for public health.
First of all, Public Health 2.0 was not properly defined in a manner of how public health leaders could work in all sectors to address social, environmental, or economic determinants of health. Changing demographics have meant a shift in the leading health challenges facing communities. Leading causes of death have been largely attributed to behaviors vs. disease or illness ( such as smoking, eating patterns, and so on).
Public health agencies have to deal with increasingly tight budgets with even higher demands. The ACA improved access to healthcare, meaning fewer people need clinical care from health agencies, leading to prioritization prevention of overall clinical care.
These ongoing challenges have led towards the re-envisioning for public health and towards the development of Public Health 3.0.
Public Health 3.0 generally refers to a new era of enhanced and broadened public health practices that take if further from traditional public agencies functions and programs. At the main center of Public Health 3.0 is the notion that local communities shall take charge of taking public health into the next level and ensure it’s an ongoing success.
Why is Public Health 3.0 necessary?
Regardless of the fact that public health’s increasing focus on how environments affect health, our Zip codes still remain am a more accurate determinant of health than our genetic codes. As a society, it’s necessary for all of us to have a collective responsibility to develop conditions that allow all members of our communities to make healthy decisions. Although, public health initiatives often exist in silos, leading into missed opportunities to leverage the vital knowledge of communities to improve health at a local level.
The main recommendations or goals for Public Health 3.0 outline practices that public health will be able to seamlessly implement in order to address any social determinants of health and increase health equity.
What are the 5 Goals of Public Health 3.0?
Public Health 3.0 mainly focuses on five core goals for public health departments in the coming new era:
● Health departments shall own the role for Chief Health Strategist, encouraging initiatives in their community, specifically upstream interventions to address social determinants of health.
● Public Health departments should become involved with cross-sector collaboration with other health departments, intra-governmental departments, and community health organizations (such as hospitals, clinics, and other local businesses).
● Health departments should search for accreditation from the Public Health Accreditation Board (PHAB).
● Health departments should take the time to gather and compile reliable, granular-level, actionable data to guide, concentrate, and assess the effectiveness of prevention initiatives, and they should make this data openly accessible to the local community.
● Funding for public health should be further amplified and substantially modified, and innovative funding models should be further explored so as to expand financial support for Public Health 3.0 leadership and prevention initiatives.
Recommended Early Actions
With the release of the report, several public and private organizations have already begun committing themselves to advance its recommendations. It was first embraced by the American Public Health Association as the blueprint for the future of public health. Others have committed to developing training methods for Chief Health Strategists or developing connections between public health and the clinical care system, including prayers. The US Department of Health and Human Services (HHS) integrated three priority recommendations, these include extending reporting on accreditation status to federal public organization, establishing a social determinants of health workgroup to support alignment of HHS policies, and launching a conversation about state-based opportunities to leverage health and human services resources to further improve the public’s health. Furthermore, CDC’s Health Impact if five-year initiative provides nonclinical, community-wide toolkits to address social determinants of health that have demonstrated not only health improvement but also cost-effectiveness within five years. Community-level uptake and action through the help of these resources could further accelerate the influence of Public Health 3.0 collaborations.
For plenty of communities, transitioning into Public Health 3.0 model shall prove quite challenging. Although funding has managed to stabilize, local health departments continue to face resource challenges from local financing streams, and proposals to further reduce federal public health spending are likely to cause a major impact at the local level.
Despite the promising advances as the Big Cities Project, the absence of non-proprietary tools for data, analytics, metrics, and other uses leave actionable information out of touch for most facilities. Moreover, the daily challenges of meeting statutory public health responsibilities and a lack of experience and skill prevents most local health leaders from becoming a Chief Health Strategists to bring people together in all sectors. Lastly, the basic foundational structure of local governmental public health may itself become a barrier to efficient and cost-effective coordination at a local level.
The era of Public Health 3.0 is going to be an exciting moment for innovation and transformation. With the Public Health 3.0 framework, a future filled with strong local public health infrastructure in all communities and its leaders servicing as Chief Health Strategists that partner with stakeholders in a multitude of sectors on the ground to handle the issues of social determinants of health. With appropriate equity and social determinants of health as guiding principles, every person and every organization will be capable of taking shared accountability to ensure the conditions in which everyone can be healthy regardless of race, ethnicity, gender identity, sexual orientation, geography, or income level.
If this becomes successful, such a transformation can lead to the foundation from which can develop an equitable health-promoting system, in which stable, safe, and thriving community is considered normal rather than an oddity. The Public Health 3.0 initiative purpose is to inspire reformation and success stories such as those already being witnessed in many pioneering communities all over the country. The current challenge is to institutionalize the expanding approach to community-based public health practice and replicate those successes all to every community, for the health and wellness of all people.