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As CEO of the National Association of County and City Health Officials, Lori Freeman spends much of her time on the road talking with the people on the front lines of public health.
It’s been a challenging year for local health departments.
The federal government in March announced it was pulling back $11.4 billion in funding allocated across the nation for pandemic response and infrastructure, an action that has been debated in the courts. More cuts are expected amid a dramatic reorganization of the Centers for Disease Control and Prevention, which has traditionally sent about 80% of its domestic budget to states, localities, tribal organizations, and other public health partners.
Meanwhile, swaths of the American public have grown increasingly distrustful of scientific and public health institutions.
Healthbeat spoke with Freeman to get her insights on five questions about some of the current challenges facing local health departments. This interview has been edited for clarity and length.
What public health concept do you wish the public better understood?
It’s this concept that from the youngest age possible, that public health is around them, keeping them safe.
They don’t see it, but they need to know that for all of their lives, that we will be there on the ground, in their community, helping to make sure that there’s safe water to drink, safe air to breathe, safe places to play and walk, safe restaurants to eat at, safe pools to swim in.
We need to make it real for them, because we just haven’t done that.
You recently co-authored a journal article titled, “Where Do We Go From Here? The Way Forward for State and Local Public Health.” The article notes that the future of public health depends on rebuilding trust with the community. What are some ways to do that?
We talk about this a lot. There is a lot of distrust right now in our federal government, and we have to not automatically extend that distrust further down to the community, because that simply isn’t the case.
Broadly speaking, our local health departments still are very well trusted in their communities. Not as much as the No. 1 primary care physician, but close up there.
For me, this is about how we retain trust, not regain trust. We had some missteps during the pandemic, but they weren’t all of our fault at local public