Population Health Blog

Population Health Blog

Why It Matters

Public Health Commission report may be ‘transformational’

By Dennis Archambault
One of the promising developments to come out of the Flint water crisis has been the Public Health Advisory Commission. As commissions go, it initially appeared to be an action that was as promising as a constructive dialogue could be – short of substantive and systemic change. That doesn’t seem to be the case, at least as far as the report goes.To begin with, the commission was well-represented with health providers, educators, non-profit executives, academicians, and several other stakeholders of the public health system. Eden Wells, M.D., MPH chief medical executive of the Michigan Department of Health and Human Services, served as chair. His comments introducing the commission’s report reflect the potential of its recommendations: “hope that the recommendations will energize a statewide effort towards a more comprehensive, cohesive, accountable and effective public health system.” He also acknowledged that the state “is committed to public health excellence, recognizing the need for change in order to truly achieve a transformational public health system.”

One should key into the word “transformational.” One might also add a word: “disruptive.”

The three top priorities for consideration are significant:
1. Create a permanent Public Health Advisory Council. This would ensure that a vehicle exists to address emerging state and local health issues;
2. Ensure all state departments employ a “health in all policies” approach when implementing policies and programs, “elevating public health”;
3. Recognize disparities in public health funding and unmet needs throughout the state.

These are only three of 39 recommendations. If the governor addresses just these three the state will be much better off. We have been advocating for a health in all policies approach to government decisions, along with others throughout Michigan. Now is the time to advocate for this method of ensuring that actions taken by government are indeed in the interest of the citzenry – certainly in the health interests of the citizenry.

Check out this report for yourself: http://www.michigan.gov/documents/snyder/PHAC_Final_Report_556718_7.pdf

Dennis Archambault is vice president, Public Affairs, for Authority Health

State public health advocates offer governor opportunity to strenghten public health integrity in Michigan

By Dennis Archambault
As Gov. Snyder considers the final report of the Michigan Public Health Advisory Commission (http://www.michigan.gov/documents/snyder/PHAC_Final_Report_556718_7.pdf) it’s an opportunity for all population health advocates to consider this moment as a potential breakthrough in struggle to improve public health in Michigan. The report submitted to Gov. Snyder includes three basic recommendations:

1. Continuing and Expanding Collaboration:
Collaboration is often talked about but seldom achieved in a world of intense competition for scarce financial resources. The advisory commission’s report recommends that collaboration be enforced to engineer a broader engagement around efficient use of public and private funds. The recommendation to establish forums for regional collaboration makes sense.

2. Collaboration between State Departments:
The essence of this recommendation is establishing a “Health in All Policies” requirement for state departments in implementing policies. It’s a process used in California and one advocated at the county level throughout Michigan. It is a means of ensuring that the health risk to our communities is properly assessed prior to state policy action. The ethical principle that underscores this recommendation is environmental justice. Too often, vulnerable populations fall victim to injustice due to a lack of voice or influence in public policy decisions.

3. Investing in Michigan’s Public Health:
Anyone working in public health, or related community health initiatives, knows that national public health expenditures has decreased steadily in the past decade. This has had a direct impact on our emergency response capability, as well as our ability to address the health impacts of poverty, racism, food insecurity, and adverse childhood experiences, as the advisory commission report confirms. In an era in which government is intent on reducing taxes and overlooking the human service infrastructure (in lieu of the physical infrastructure and military), advocates need to convince elected officials that this is not an issue limited to vulnerable communities and populations – even though pockets of vulnerability are showing up in seemingly affluent communities. Just as roads deteriorate if they aren’t maintained, so does the social infrastructure.
The governor asked representatives from the public health sector for their advice. They have provided a very thoughtful and comprehensive report. Now it’s up to the governor and legislature to determine if they really want ensure good public health in Michigan.

Dennis Archambault is vice president of Public Affairs for Authority Health.