Transformation & Modernization

Public health transformation requires reimagining and developing a common vision to ensure the mindsets, capacity, resources, and workforce necessary to provide equitable Foundational Public Health Services and Essential Public Health Services, to advance health, wellbeing, and equity. It occurs through a fundamental shift in the way a public health system(s) is structured, functions and interacts through continuous quality improvement, innovation, partnerships, community-led efforts, and systems change.

Simply put, it requires sustaining what is working, building on what can be improved, and reimagining what could be so that all people and communities can thrive.

Now is the time to reimagine and transform public health systems to best advance health and equity. PHNCI is supporting states in intentionally transforming and modernizing their governmental public health systems to create equitable public health systems and communities.

Our approach to transformation and modernization is through building and strengthening governmental public health infrastructure and systems to create change that improves health. It requires centering equity, modernizing data systems, and equipping our health departments with foundational capabilities and workforce needed to serve, rebuild trust, and be accountable to their communities.

This cannot be achieved by doing business as it has been done – it requires bold thinking, incremental and radical change, and innovation. It requires centering equity, modernizing data systems, and equipping our health departments with foundational capabilities to serve their communities.

Current efforts include using frameworks such as the Foundational Public Health Services and the 10 Essential Public Health Services, learning from communities like the 21st Century Learning Community, Cross-sector Innovation Initiative, and All In: Data for Community Health, Staffing Up, a workforce initiative to support efforts to ensure sufficient funding for the public health system in the United States, and accreditation.

Stakeholders are engaging in these efforts in a variety of ways across public health systems. States are using the Foundational Public Health Services and other models for modernization and transformation. Federal and national organizations are working collectively to develop recommendations for the future, like Public Health Forward, Recommendations from the RWJF National Commission to Transform Public Health Data Systems, and more.

Through new and expanding initiatives, PHNCI is engaged in a variety of initiatives aimed to support public health departments and public health practitioners that are using innovative practices as a tool to drive transformation. New efforts are outlined below.

PHNCI is expanding our transformation and modernization efforts to:

  • Actively recruit and onboard new states for 21C;
  • Define public health transformation and what reimagined public health systems could look like on a state-by-state basis;
  • Engage up to three 21C state public health systems to begin implementing RWJF’s National Commission recommendations;
  • Develop a strategy and guide to support states in utilizing federal funding to intentionally advance modernization efforts;
  • Create opportunities for sharing emerging practices from states around service sharing, workforce models, costing and assessment, and more;
  • Foster an understanding of commonalities/differences in various transformation efforts to advance learning;
  • Identify opportunities for alignment across related initiatives.

Thank you to the Robert Wood Johnson Foundation for their continued support.

PHNCI is home to the 21st Century Learning Community (21C), a group of states focused on intentional state-wide public health system transformation; these states are driving transformation in their state and generating a knowledgebase for the field.

21C states are at the forefront of envisioning what transformed public health looks like. To achieve that vision, they are using various state approaches-- such as the Foundational Public Health Services (FPHS), accreditation, Public Health 3.0, and more -- to strengthen infrastructure, improve performance, and rebuild trust in and accountability to their communities.

Learn more about applying to become a 21C state, current 21C states, expansion updates, and learnings here.

To serve our communities equitably, governmental health departments need access to modern, real-time, hyperlocal data and tools. These are critical in understanding the needs of our communities, making data-driven decisions that address community priorities, and transforming public health infrastructure. Governmental public health in the United States currently lacks modern data systems and structures to do this, which have had a direct and negative impact on health and equity.

PHNCI has increased our focus on data modernization and will:

  • Focus on data modernization efforts as part of our 21C initiative expansion.
  • Engage several 21C state public health systems to begin implementing the Robert Wood Johnson Foundation’s National Commission to Transform Public Health Data Systems recommendations.
  • Develop an excellence recognition program that recognizes health departments who are conducting exemplary work related to data modernization and will be designed to highlight work that exceeds the PHAB accreditation standards.
  • Ensure coordination across various national and regional initiatives focused on public health transformation and modernization to share practices, data, and align efforts as appropriate.

Learn more about our data modernization efforts here.

From September 2020 to June 2021, PHNCI at PHAB partnered with the de Beaumont Foundation on the Staffing Up workforce initiative to develop a national estimate of staffing needed to perform the Foundational Public Health Services. Analysis revealed that the United States needs 80,000 more full-time-equivalent positions in state and local health departments to provide basic community services, and 80% increase just to provide a minimal set of services that every community needs.

In Summer 2022, the de Beaumont Foundation, PHNCI at PHAB, and the Centers for Disease Control and Prevention’s Center for State, Tribal, Local and Territorial Support will release a public health workforce calculator that builds upon the work of the estimate. The calculator will allow health departments to determine the number and type of staff to provide sufficient levels of public health services.

Learn more about the Staffing Up estimate and calculator here.

To live up to our commitment to promote and protect the health of all, governmental public health systems must work to promote equity and to reduce disparities. This is done by centering equity, modernizing data systems, and equipping our health departments with foundational capabilities to serve their communities. Through accreditation and innovation at the Public Health Accreditation Board (PHAB), significant work is being done to transform public health practice and communities across the country.

Equity is emphasized in Version 2022 of the PHAB Standards & Measures. These requirements for accrediting health departments are aligned with the 10 Essential Public Health Services. Public health services should actively promote policies, systems, and practices that create conditions where all people can thrive, and remove structural barriers that result in health inequities, such as poverty, racism, and discrimination. By infusing equity in all domains of Version 2022 of the Standards & Measures, PHAB is encouraging health departments to focus on advancing equity in their communities.

Learn more about the relationship between accreditation, innovation, and transformation here.

Is your organization working on an initiative to transform the public health system? We want to hear about it! Please email [email protected] with details.