Strategic Goal 2

Health security threats expose and worsen health disparities, diminish overall population health, create negative economic impacts, and reveal weaknesses that need to be addressed at multiple levels of preparedness, planning, and response. The limited collection and reporting of demographic data created an incomplete picture of COVID-19’s disproportionate impact on underserved populations. Without nationally representative data that accounts for the specific lived experiences of all populations, response actions, decision making, and allocation of resources can be ineffective.

Establishing standardized and inclusive demographic data elements that crosscut public health surveillance systems can enhance preparedness, response, and recovery for underserved communities and at-risk individuals. Public health surveillance data should better represent these socioeconomic and demographic groups to better assess and understand the full scope of health impacts. Expanding research on social determinants of health and incorporating those data (e.g., limited income and lack of accessible primary health care) into surveillance systems will provide greater insight into the disparities that underserved communities face. The U.S. government, HPH sectors, and community partners can work together to ensure uniform collection and reporting of race, ethnicity, disability status, and other demographic and socioeconomic data indicators to enhance reporting, create new analysis tools, and strengthen response. In addition, working with underrepresented communities with a focus on data transparency and ensuring privacy will build trust in data-driven decision making.

Agricultural expansion and changes in land use can lead to negative impacts to both human and animal health, including exposure to pathogens and emergence of new diseases. Encroachment on wildlife habitat and wet markets are prime locations for pathogen spillover events. Furthermore, the use of antibiotics in livestock also poses the potential to give rise to new antibiotic resistant pathogens.

Continued investment in animal and plant health diagnostic tools, implementation of more sustainable land and antibiotic use practices, and closer monitoring of domestic and international animal trade can better protect agricultural production systems, food production workers, and reduce disease outbreaks. Innovative animal and plant health diagnostic technologies, standards, and other surveillance measures are critical to detecting and preventing animal and plant diseases prior to human infection. By strengthening domestic and international partnerships with agricultural and environmental stakeholders, the United States can expand surveillance, detection, and reporting capacity in wildlife, livestock, companion animals, and other animals with high spillover risk. In addition, dedicating greater resources and expanding international cooperation to increase enforcement of wildlife trade regulations, including at points of entry, can also mitigate the risk of spillover events and diseases entering U.S. territory.

Promoting sustainable agricultural practices can protect the health of plant and animal populations while also improving U.S. food safety and food security. One potential line of effort is to increase investment in applied research of locally relevant interventions that increase the health of animals and reduce the incidence of infections along the food value chain.

The increased reliance on technology makes HPH systems and data vulnerable to cybersecurity threats. Cyberattacks on health care Information Technology (IT) can cause providers to lose access to vital patient information, disrupt delivery of care, and cause medical devices to malfunction. The potential breach of health care data, including electronic health records, could put patient privacy at risk.

A U.S. health system that cultivates cybersecurity resilience, establishes minimum standards of security, and maintains evidence-based cybersecurity solutions will help minimize risks and vulnerabilities to cybersecurity breaches. Collaboration between HPH systems and IT partners can establish and govern feasible security standards for technology, data systems, and medical devices used at health care facilities. As telehealth continues to be expanded, health care and IT partners should work in conjunction to safeguard patient privacy. Developing a one-stop platform maintaining guidance and cyber hygiene practices for meeting those standards will further assist health care facilities with safeguarding their technology. There also needs to be increased investment in resources and preparedness activities that increase cybersecurity (programs, personnel, upgrading or securing legacy systems). Promoting mitigation and response plans for cybersecurity breaches or attacks in the health sector can foster a healthy cybersecurity environment across HPH organizations.