health system—including potential actors in the private and nonprofit sectors—this report proposes six areas of action and change to be undertaken by all who work to assure population health. These areas include

  1. Adopting a population health approach that considers the multiple determinants of health;

  2. Strengthening the governmental public health infrastructure, which forms the backbone of the public health system;

  3. Building a new generation of intersectoral partnerships that also draw on the perspectives and resources of diverse communities and actively engage them in health action;

  4. Developing systems of accountability to assure the quality and availability of public health services;

  5. Making evidence the foundation of decision making and the measure of success; and

  6. Enhancing and facilitating communication within the public health system (e.g., among all levels of the governmental public health infrastructure and between public health professionals and community members).


Governmental Public Health Infrastructure

Finding: Public health law at the federal, state, and local levels is often outdated and internally inconsistent. This leads to inefficiency and a lack of coordination and may even pose a danger in a crisis requiring an immediate and effective public health response. Pioneering work at the national level has gone into developing models and guidance to assist states in reforming their public health laws as appropriate for their unique legal structures and public health preparedness needs, but a more comprehensive effort is needed.

  1. The Secretary of the Department of Health and Human Services (DHHS), in consultation with states, should appoint a national commission to develop a framework and recommendations for state public health law reform. In particular, the national commission would review all existing public health law as well as the Turning Point1Model State Public Health Act and the Model State


Turning Point, a program funded by the Robert Wood Johnson and the W. K. Kellogg foundations, works to strengthen the public health infrastructure at the local and state levels across the United States and spearheads the Turning Point National Collaborative on Public Health Statute Modernization.

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