How can we prioritize equity in public health

New Jersey ranks 31st in the United States in state funding for public health, according to the Trust for America’s Health. And a report from Rutgers University found that New Jersey has the lowest median per capita state appropriation for public health among states the study examined. New Jersey’s public health workforce, on a per capita basis, is among the smallest  among states in the comparison—only half that of regional neighbors Connecticut, Maryland, and Massachusetts, the Rutgers report stated.

Another part of the problem is New Jersey’s unusual governance structure. The Garden State has a heavily fragmented system for delivering services, hampered by its “home rule” fondness for local control. The result is a state divided into 565 municipalities and over 600 school districts. “Seizing the Moment,” a report supported by the Robert Wood Johnson Foundation (RWJF), the Nicholson Foundation (Nicholson), and National Network of Public Health Institutes (NNPHI), notes that this arrangement impedes cross-sector, cross-regional collaboration that—in other states—helps attract funding, develop expertise, and build capacity to more effectively deal with public health problems. A public health institute in New Jersey could offer the health coordination our state sorely lacks and complement the work of the state, local, and regional public health departments.

In Virginia, the Institute for Public Health Innovation in 2020 assisted in rapidly building up human capacity to respond to COVID-19. In under a month, the Institute recruited, hired, and trained 80 new staff. By the end of January 2021, it had added over 640 people, including case interviewers, contact tracers, community health workers, epidemiologists, environmental health specialists, call center staff, wellness specialists, and response team managers. As the pandemic response shifted to vaccine access, some team members began assisting that effort. More than half of the Institute’s deployed staff are people of color, and staff report speaking over 60 different languages.

In 2017, the Public Health Institute of Metropolitan Chicago conducted a landscape analysis of home-visiting services in partnership with the city’s Department of Public Health to improve services for pregnant women and children and reduce system inefficiencies. This helped guide a strategy for developing a vision and strategy to coordinate maternal child health and early childhood home-visiting services in Chicago.

In these instances—and many more across the nation—public health institutes contributed to significant accomplishments well beyond the capacity of other health entities.