Strategic Goal 1

Disruptions in critical infrastructure and an influx of patients can hinder access to and delivery of health care, especially for people in underserved communities. The nation’s health systems and infrastructure will continue to be stressed as extreme weather becomes more severe and diseases continue to emerge. Response activities can divert resources otherwise needed for delivery of routine care for chronic disease patients and persons with disabilities. These interruptions in health care access and delivery for underserved communities can further undermine efforts to ensure health equity.

Resilient and adaptive HPH infrastructure and data systems, including national clinical research capacities, that are ready to respond to public health emergencies and disasters, no matter the threat, will ensure continuous access to health care for all populations. Incorporating multiple threats and climate change considerations into preparedness, mitigation, response, and recovery planning can improve the readiness of HPH systems. Additionally, promoting infectious disease mitigation strategies such as indoor air filtration, ventilation, and air disinfection technologies can further protect patients in health care settings. 

Emergency planning should include tiered networks that coordinate national expertise with regional, state, and local capabilities and capacity to increase access to specialty care and surge capacity, including for pre-hospital emergency medical services and post-hospital health care and social services. By expanding agreements permitting providers to offer care outside their licensed jurisdiction during emergencies, states and territories can increase assistance. Standardized guidance and a common platform with resources on liability protection and crisis standards of care implementation can streamline deployment of health workers during an emergency. 

Additional resources for HPH infrastructure to strengthen their physical resilience to climate change will improve readiness for the impact of extreme weather events. During a disaster, impacted patients could face barriers to health care access due to their geographical spread, mobility concerns, and transportation needs. To address this, expansion of emergency-use strategies for telehealth, including extended payment benefits for in-home visits, and coordinated development of deployable, telehealth critical care systems to ensure equitable care are necessary to ease the burden of a potential surge on health care facilities and public health infrastructure.

Expanding health system capabilities and capacity also need to reach at-risk individuals and underserved communities. Reaching those populations before a disaster occurs will allow public health authorities to better understand the consequences of emergencies on the most vulnerable and prioritize their health needs in emergency response and recovery planning. Additionally, mental and behavioral health should be integrated into emergency preparedness, response, and recovery plans with dedicated resources aimed towards recovery and long-term resilience.

Public health emergencies and disasters continue to strain the HPH workforce. They have caused staffing shortages and workforce burnout, resulting in shortfalls during response and longer-term recovery efforts, limitations in critical expertise, disruptions in care for chronic disease patients, and diminished preparedness against future threats. Due to these challenges, additional resources are needed to recruit, train, and retain HPH workers who are embedded in communities and have the expertise to respond to a wide array of threats. 

A robust and well-resourced health care, research, and public health workforce will ensure the U.S. can respond rapidly to national health security threats and maintain the health of communities. Incentivizing public health and medical careers can expand employment opportunities. This expansion should aim to diversify the workforce by actively recruiting underrepresented racial, ethnic, and disability groups and increasing placement in rural and underserved communities. Furthermore, developing worker resilience strategies (e.g., flexible work schedules, wellness training, self-care) can mitigate burnout during emergencies and promote higher retention.

In addition to workforce expansion, current and future health workers should receive training in disaster preparedness and emergency response, including standard and transmission-based precautions, emergency response research support, use of personal protective equipment for high-risk infectious diseases, and responding to multiple threats simultaneously. 

Ineffective emergency risk communication can prolong response time, diminish the efficacy of recovery operations, and sow societal mistrust of public health and medical response measures. During emergencies, information rapidly evolves, and inconsistent information is often shared in the news media and on social media platforms. Without comprehensive data about how a national health security threat is impacting diverse communities, delivering plain language communications that are tailored to health literacy levels and other specific needs is a challenge. 

An effective risk communication system that delivers plain language and consistent evidence-based messages can reduce confusion and restore trust in public health interventions. Effective and unified public health communications during an emergency should emphasize transparency with the public in how public health decisions are made, using plain language messaging. These communication campaigns should follow the National Standards for Culturally and Linguistically Appropriate Services in Health and Health care and be made accessible to persons with disabilities and individuals with Limited English Proficiency. Messaging and communications should be adapted at the local level with bidirectional input from diverse community representation. Communication outreach that incorporates the specific ethnic and socioeconomic needs of each community will further support effective public health messaging. Federal and SLTT public health officials should partner with trusted messengers within communities to promote community trust in non-pharmaceutical interventions, MCMs, and other public health interventions.

During an emergency that is constantly evolving, real-time changes to information coupled with partisan distortion of data can make it difficult for the public to determine which information is accurate and what sources should be trusted. Having mechanisms in place to identify, track, and counteract Mis-Dis-Mal health information can reduce confusion and increase uptake of critical public health measures. Health Mis-Dis-Mal information should be viewed as a whole-of-society problem requiring unified action by government stakeholders, commercial entities, medical organizations, and community leaders and other segments of civil society. 

HPH stakeholders should partner with emergency management authorities, trusted community leaders, and media organizations to provide the public with guidance on how to identify reliable information and what to consider when deciding to share information. Technology platforms can partner with the HPH organizations to build additional tools and processes to monitor and eliminate health mis-dis-mal information. Finally, stronger collaboration between the public health sector and communication and behavioral health experts can improve understanding of the public’s susceptibility to health mis-dis-mal information and how people consume information during crisis situations.