Health and Well-Being Matter is the monthly blog of the Director of the Office of Disease Prevention and Health Promotion.
The declaration of the COVID-19 public health emergency officially ends on May 11, 2023. This moment reflects the progress that has been made throughout the acute phase of the pandemic – including decreasing rates of deaths and hospitalizations. Still, many challenges continue. Exacerbations of pre-existing public health concerns – including inadequate access to preventive health services and increasing prevalence of preventable chronic disease, as well as new issues such as long COVID – will demand our attention going forward, even as we learn to better live with evolving strains of coronavirus. This moment also marks the end of many programs, flexibilities, and funding opportunities developed under the emergency declaration; changes that will necessitate adaptation of existing resources to meet continuing and expanding service needs. As we transition to the next chapter of public health, it’s imperative that we carry forward and apply all that we have learned from the past few years to ensure optimal recovery, improved health and well-being, equity, and enhanced resilience.
What we’re seeing lately in terms of the burden of disease due to COVID-19 (as of this writing) is mostly positive news. The current trendlines show that cases, hospitalizations, and deaths due to COVID-19 are declining. Almost 70% of the American public has completed at least the primary series of COVID-19 vaccinations. With the help of the vaccines and other mitigation strategies, opportunities to enjoy social gatherings with family, friends, and loved ones resemble those that we knew prior to the pandemic. But that is not to say that COVID-19 is no longer a concern.
COVID-19 continues to take hundreds of American lives per day. And, less than 17% of the public is up-to-date on their recommended booster doses, with inequities contributing to ongoing marked disparity in outcomes. Long COVID affects 1 in 5 Americans with an array of symptoms, varying duration, and significant differences in severity. And, the pervasiveness of misinformation confounds many public health initiatives, erecting new obstacles to effective disease prevention and health promotion efforts.
All of this is in addition to the public health concerns that we faced before the COVID-19 pandemic that have continued – or in some cases worsened – over the past three years. We’ve seen a decrease in levels of physical activity, a growing mental health crisis, particularly among our nation’s youth, diminished uptake in preventive services, and a deepening of existing health disparities. I note these things not to paint a dismal picture. Rather, I mean to suggest that this represents an historical moment to evolve public health toward meaningful, far-reaching, favorable health outcomes for the Nation.
Public health crises have occurred throughout history. And the work of public health has evolved. So too will our work as we define the end to the emergency conditions of the COVID-19 pandemic and the future of public health as a result of this experience. We will reflect on the lessons that have been learned; not just in the way that we prevent, detect, and respond to emerging infectious diseases, but also – and perhaps even more importantly – how we enable and empower individuals and communities to achieve and sustain greater health, well-being, and resilience.
There’s much to reflect on from the past three years – far more than I can possibly share here or of which I am likely even aware. But I do want to note three takeaways from this pandemic experience that I feel strongly about.
The first is that striving for equitable resilience for all must be a priority. I consider a resilient community to be one that maintains an optimum level of physical, mental, emotional, and social health and well-being, grounded in principles of equity. Degrees of resilience define an individual or community’s ability to weather disruptions – chronic or acute. As I wrote in a previous blog on establishing enhanced resilience, COVID-19 has clearly demonstrated what we already knew to be true: a diminished baseline level of resilience is reflected not just in a single person’s vulnerabilities, but also in the vulnerabilities of family, friends, community, and even the nation. Focusing public health and aligned efforts toward not only improved health but also improved well-being, opportunities to thrive, and ultimately enhanced resilience, especially in light of what we’ve just been through, is imperative.
I’d encourage us all to reexamine the initiatives, resources, and tools that guide our national efforts to establish this resilience. That includes working towards the objectives in Healthy People 2030, more intentionally focused on social determinants of health than ever before in its 40+ year history. It also means promoting individual health, well-being, and resilience through increased physical activity and better nutrition as called for in the National Strategy on Hunger, Nutrition, and Health and as described in the Physical Activity Guidelines for Americans and the Dietary Guidelines for Americans. For our government partners it means leveraging the framework of the Vital Conditions for Well-Being and recommendations that are outlined in the Federal Plan for Equitable Long Term Recovery and Resilience toward more meaningful impact of federal resources on communities.
The second takeaway from the pandemic is the imperative to maintain awareness of the importance of social determinants and vital conditions in defining opportunities for better health, well-being, thriving, and resilience. Healthy People 2030 provides a broad perspective on our most pressing public health priorities through its 358 measurable objectives, 23 Leading Health Indicators, and Overall Health And Well-Being Measures. It also provides data tracking tools, Evidence Based Resources, and other materials to support efforts to track progress, plan, and guide public health throughout this decade. Healthy People 2030 includes, amongst the initiative’s 5 overarching goals, one specifically related to social determinants of health that aspires to “create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.”
And finally, I’ll repeat something that I’ve written about before: we need to all be in this together. Action that flows from this new perspective demands not just an evolved public health sector. It demands a whole of society approach centered on shared stewardship for healthier, more resilient communities. With the end of the public health emergency comes the end of many supplemental supports and emergency funding. That necessitates all manner of adjustments, not the least of which is managing sustainable resources that ensure continued, uninterrupted services. Innovative partnerships will be an important way to adapt. However, the benefits of shared stewardship extend far beyond efficient management of resources. We cannot possibly realize an equitably more resilient future without such common effort.
Yours in health,
Paul Reed, MD
Rear Admiral, U.S. Public Health Service
Deputy Assistant Secretary for Health
Director, Office of Disease Prevention and Health Promotion
In Officio Salutis — In the Service of Health