Opinion: As Public Health Emerges From the Shadows, It’s About Time

Fran Phillips, deputy secretary of the Maryland Department of Health. Photo by Danielle E. Gaines.

A decade ago, Maryland’s Deputy Secretary for Public Health Services, Fran Phillips, stated, “If we [public health] had a Facebook page, the Women’s Coalition for Health Care Reform would be our only friend.”

At that time the state was putting in place strategies to fully implement the Affordable Care Act, whose birthday we just celebrated. The year before, Phillips had led Maryland’s response to the 2009 H1N1 epidemic.

Today, she is, once again, the Deputy Secretary at the Maryland Department of Health where she is a leader on the state’s response to the Novel Coronavirus (COVID-19).

Since Phillips made that statement, public health has gained a few more “friends.” Using the Maryland Public Health Association (MdPHA) as the marker, they now have 1,134 friends on Facebook and 690 on Twitter.

These modest gains belie a disturbing reality — support for public health, as reflected in its budgets, has been declining. We see that in cuts at the federal level, including those at the Centers for Disease Control and Prevention (CDC), as well as in our own state where budgets of county local health departments have seen substantial decreases.

One reason may be that elected officials, decision-makers, and the general public do not understand the impact of public health on our daily lives.

Dr. Georges Benjamin, a former Maryland secretary of health, has said that the discipline of public health “gives everyone the opportunity for good health.”

Or, as the American Public Health Association, which Benjamin now leads, says, public health “saves money, improves our quality of life, helps children thrive and reduces human suffering.”

Local health departments include inspectors who ensure that there are no rats in the kitchen of our restaurants. Today, county health officers, epidemiologists, and others are working 24/7 to track and fight COVID-19.

We are all indebted to them for their dedication to ensuring our safety. But we must not ignore the fact that, when this scourge is under control, we cannot return to an era of complacency where public health has too little funding and few friends. We must address the world as we see it today, while also looking to the future.

For centuries leaders have spoken to the importance of finding opportunities in the darkest hours. Of those, perhaps the most apt is this one from John F. Kennedy, speaking at the United Negro College Fund in 1959: “When written in Chinese, the word ‘crisis’ is composed of two characters. One represents danger and the other represents opportunity.”

Governor Hogan, the members of his administration, and those who are working on the front lines deserve our sincere thanks for providing true leadership to address the current dangers. But, we must also ask that they seize the opportunity afforded by this crisis. One positive step would be a strategic planning process with two primary goals:

  1. Reverse the funding cuts of the last decade to ensure that local health departments and community-based health clinics and organizations have all resources they need to do their jobs effectively each day; and

  2. Identify resources required for the next public health crisis and make a plan to secure these when and where they are needed. Face masks, ventilators, and hospital beds now are in short supply. We also will need larger numbers of medical professionals and support staff.

The 2020 Maryland General Assembly passed, and the governor signed, critical legislation to address COVID-19. Now they have an important role in setting policy and providing funding to secure the health and well-being of all Marylanders in the future.

This will require a collective effort with important roles not only for elected officials and policymakers but also for community-based organizations, advocates and the public.

Now that public health has emerged from the shadows, albeit in a way none of us would have wished, it is time for Maryland to build a system that will meet all of our 21st Century challenges.

— LENI PRESTON

The writer is a health policy and consumer advocate.