CDC Director Tom Frieden Offers Encouragement, Challenges to State and Territorial Health Officials

Sep 20, 2013, 10:21 AM


GUEST POST by Lisa Junker, CAE, Director of Communications at the Association of State and Territorial Health Officials (ASTHO).

The United States is facing a “perfect storm of vulnerability,” said U.S. Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, MPH, yesterday at the 2013 Annual Meeting of the Association of State and Territorial Health Officials (ASTHO)—and state and local public health officials are on the front line of defense.

Frieden began his remarks by encouraging his listeners to “go back to first principles” and keep in mind the first priority of government, which is to keep people safe.

“If the government can’t keep people safe, whether it’s the police or us in public health, we are failing at our number-one responsibility to the public,” Frieden said.

And to keep the U.S. population safe today, public health officials have to keep their eyes open for threats arriving from outside our borders. Infectious diseases, drug resistance, new pathogens, intentional engineering of microbes, and globalization of travel, food and medicines: “If there’s a blind spot anywhere, we’re at risk everywhere,” Frieden emphasized.

He also focused on CDC’s partnership with state and local public health, even during the current tight fiscal atmosphere.

“Overall, our approach has been to double down on support for the front lines [state and local health agencies],” he said. “We all are in this together…We have lots of problems and lots of opportunities, and the more effectively we are connected, the more effectively we can address these opportunities.”

Citing the success of the CDC ‘Tips from Former Smokers’ campaign, which resulted in more than 100,000 smokers quitting for good in 2012 alone, Frieden encouraged state and territorial health officials to find ways to increase their funding of media campaigns. In his discussion of the Tips campaign, he took a moment to remember the late Terrie Hall, a North Carolina resident who was featured in Tips ads and who died of cancer on Sept. 10. One of her Tips videos was the highest-impact ad CDC has ever produced, with 2.5 million views. The weekend before her death, Hall asked CDC to film her in her hospital bed so she could continue to spread the message about smoking.

“She probably saved more lives than most doctors will save in their entire career,” Frieden said.

Frieden also focused on the importance of increased collaboration between public health and healthcare, calling this “the most important challenge of the next decade.” “If we don’t get this right, we’ll be left out,” he said.

He ended his presentation with a “medley” of four key issues for his audience to consider. First, he cited the need for improvement in the public health aspects of Meaningful Use for health information technology.

“We won’t be in the game in Meaningful Use stage 3 if we don’t show we can be good partners in Meaningful Use stage 2,” Frieden said.

Second, he also expressed concern about the public health workforce, citing ASTHO and National Association of County and City Health Officials (NACCHO) research showing that there are 46,000 fewer people in state and local public health agencies due to contraction caused by the economic downturn. He encouraged state and local health officials to actively communicate about what has been lost due to these reductions in staffing so that it’s clear why that workforce is needed when the economic environment improves.

Third, Frieden spoke about the need to “rightsize” public health laboratories, saying, “If we didn’t have a public health laboratory system, what system would we build? It wouldn’t look anything like what we have today.” He suggested that states might need to look at a regional approach for their laboratories, among other options.

Frieden closed with a look at the role of government in public health. He identified three key roles for governmental public health efforts: to share information (“if you increase the information available to people, you increase their freedom … you increase their ability to make choices,” he said), to protect people from harm caused by others, and to take societal action to protect and promote health.

In a Q&A session after his remarks, Frieden was asked, “What would you hope your legacy would be as a CDC director?” Frieden responded, “I want to make sure that CDC is stronger and more effective. That means that we’re more connected with you at the state and local level; that means that we have better information available in real time…that means that we’re making a bigger difference in the health in all policies arena. Fundamentally, it means that we’re improving health.”

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This commentary originally appeared on the RWJF New Public Health blog.