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Community health workers can fight COVID and historic inequities


As the Biden administration begins implementation of its strategy to address the COVID-19 pandemic, attention is being given to the need for a rapidly scaled workforce that can meet this emergency. But speed must be combined with care — as we hire workers who will be able to fill gaps in our current public health and community workforce and meet the needs of the communities most adversely affected by the pandemic.

Indeed, the President’s executive order on a sustainable public health workforce recognizes this.  He directs the secretaries of Health and Human Services, Homeland Security, Labor, and Education along with the CEO of AmeriCorps to develop a plan with “five-year targets and budget requirements for achieving a sustainable public health workforce, as well as options for expanding HHS capacity, such as by expanding the U.S. Public Health Service Commissioned Corps and Epidemic Intelligence Service, so that the department can better respond to future pandemics and other biological threats.” 

In the context of the executive order, what constitutes public health functions are narrowly described, usually referencing testing and contact tracing along with vaccination outreach and delivery. But as the President’s overall pandemic strategy recognizes, building a stronger system that can prevent or reduce the impact of a future pandemic means much more than this. It means building a public health system that has a workforce that can:

Thus, as this workforce plan is developed, the designated federal officials need to think more broadly so we make a long-term plan to support the institutions and individuals who will comprise a workforce that:

While the pandemic has certainly highlighted many weaknesses in our public health and social services systems, there are assets throughout the nation from which to build. 

To cite just two examples, we have the capacity to expand the size and role of the Public Health Service Commissioned Corps to address public health workforce needs or expand funding and training for community health workers through Medicaid reimbursement or Departments of Labor and Health and Human Services programs. 

That said, a significant new investment will be needed. One example would be passage of the Public Health Infrastructure Saves Lives Act, which would provide permanent funding to state and local health departments to build a workforce that could deliver all of the critical foundational capabilities for those who reside in health workers’ communities.

In short, as we urge expansion of the health workforce to meet immediate needs, we should also “build back better” so those mobilized during the emergency can be a part of strengthening our public health system in the longer term — with appropriate training, career ladders and sustainable funding for their positions.

Jeffrey Levi, PhD, is professor of health policy and management at the George Washington University, where he leads the Funders Forum on Accountable Health which focuses on improving population and community health through multi-sector partnerships.