>> Hello. I'm so pleased to meet you.
Today you have just the virtual me but one day soon I look forward to being with you in person.
I want to start by thanking each of you for your dedication and commitment to public health
and your service on the Task Force.
I appreciate your long-standing commitment to advancing population health
through recommendations for evidence-based interventions
and your partnership with CDC to make this happen.
Thank you.
If we were meeting in person, I'm guessing you might ask me the same question I hear from many,
"how are we doing on the pandemic?"
I'm happy to report that here in the United States we have made great progress
in the fight against COVID-19.
And while I'm not yet declaring victory, I'm cautiously optimistic we are
on the path to a more normal world.
As each week passes, the decreases in cases, hospitalizations, and deaths give me hope.
As we work toward vaccinating the entire country, one-by-one,
we are meeting people where they are.
We are listening to their concerns.
We are helping people make informed decisions about vaccinations. And we are working
with governors and local leaders who are looking at their case transmission and vaccination rates
to make data-driven policies about how to safely get back
to activities we lost during the pandemic.
You may know that, before I accepted the honor of leading CDC,
I served as chief of the Division of Infectious Diseases at Massachusetts General Hospital.
At Mass General, I, too, was serving on the frontline of the COVID-19 pandemic.
And like you, I was thinking through how we could reach underserved communities
and incorporate evidence-based guidance into our treatment and vaccine delivery strategies.
In this work, I built on the many years I spent doing research to advance our efforts
to end the HIV epidemic both domestically and around the globe.
I am particularly happy to be with you today
because of the important work the Community Preventive Services Task Force does building
healthier communities.
You and I know that community-based solutions ensure that we reach those most
in need by meeting them where they are.
Your recommendations help communities decide how to use what are often limited resources
when tackling public health issues.
And you thoughtfully decide which of the many complex public health issues should become our
next research priorities.
I read, with interest, your recent recommendations supporting the use
of clinical decision support systems to increase HIV screening,
an intervention I have championed for the past two decades.
And at this meeting, you'll be talking about your systematic review on HIV prevention,
partner services interventions to increase HIV testing.
I look forward to hearing what is decided.
I also am eager to learn of the results from your economic evaluation of team-based care
to improve blood pressure control.
Like you, I have a keen interest in both the clinical and economic impacts
of policy decisions and how they affect
who ultimately receives access to the care we recommend.
Your recent recommendation on tenant-based housing voucher programs
to advance health equity speaks to another topic
that is very important to me, health equity.
From my first day on the job at CDC, I have made it clear
that health equity must be at the core of everything we do.
As an agency, we recognize the systemic nature of the inequities that exist
in our nation's healthcare infrastructure.
While we all saw these structural inequities before, the pandemic has made it clear to all
that we cannot be healthy as a nation until all of us can access healthcare.
If we were together, you might ask about my other priorities for the agency.
You would hear that I believe we need to make investments in four critical areas.
We must invest in the public health workforce.
We must invest in preparation for future health threats both global
and domestic including strengthening our public health laboratory infrastructure.
We must invest in data modernization. And we must invest
in the hard work of ensuring health equity.
Our public health workforce has been sadly diminished.
In the past decade, we have lost over 60,000 public health jobs.
On May 13th, the President announced the exciting news of an investment of $7.4 billion
from the American Rescue Plan to recruit and hire public health workers.
Our thanks go to Congress for providing these resources.
These will begin to provide for public health safety of our future.
These resources will build a public health workforce that is technically expert, upskilled,
and reflective of the diversity within the communities they serve.
And it will help us provide stable resources so public health departments can recruit,
adequately compensate, and retain their workforce.
With this funding from the American Rescue Plan comes a new $3 billion multi-year grant program
to provide under-resourced health departments with the support they need
to build a public health workforce that represents the communities in which they work.
Our goal is to build a new grant at CDC, not tied to a specific disease or risk factor,
that can be made available beyond our traditional jurisdictions.
We are not planning for 2022.
We have to plan for 2040 and 2050.
What will our public health infrastructure need to look like in 20 or 30 years?
For example, just as budgets for the public health workforce have been slashed,
our public health laboratories have also been sadly under-funded.
State public health labs are the nations first line defense
against an infectious disease threat because they handle the early diagnostic tests.
Lab closures and funding delays for equipment have hampered our response to COVID-19
from the very beginning, and these reductions in funding have come despite repeated warnings
that the result was a public health system that was not prepared
for a pandemic or biological attack.
A third investment we must make is investing in the modernization of how CDC
and public health collect, use, and share data.
The better our data, the better our science, and ultimately the result is better guidance.
At the beginning of the pandemic, we still had public health departments faxing their
information to us, which required us to manually enter the data on our end.
You can imagine the delays and the opportunities for error that caused.
How can we face a 21st-century pandemic with such woefully outdated tools?
CDC's data modernization initiative is our first ever data-focused strategy
that is both resourced and comprehensive.
The funding from the American Rescue Plan also includes $80 million for the Office
of the National Coordinator for Health Information Technology, or ONC,
to train public health professionals to help modernize the public health data infrastructure
and will focus on recruiting from minority- serving institutions and universities.
The investment will also help us address gaps identified by the COVID-19 pandemic
in our public health data reporting and analysis such as race- and ethnicity-specific data.
And all of this is connected to, and an integral part of, our investment in public health equity.
The impact of COVID-19 has been felt most severely in communities of color,
communities that have experienced disproportionate case counts and deaths.
This is where the social impact of the pandemic has been most extreme.
There are many data points around the pandemic that give me pause but perhaps none more
than when we look at the statistics about the years of life expectancy lost because of COVID.
Life expectancy dropped 0.8 years for whites, 1.7 years for Latinos,
and 2.9 years for Black Americans.
The pandemic has illuminated inequities that have existed for generations and revealed
for all of America a known but often unaddressed epidemic impacting public health---racism.
These disparities exist not only for COVID, but for chronic diseases, mental health,
opioids, and the health impact of climate change.
We cannot lose focus on addressing ongoing issues that contribute
to significant morbidity and mortality.
Better data will help us overcome the information gaps that keep us
from seeing the degree to which some populations experience health inequities.
As a physician, I saw firsthand the perils of inequity.
When you enlarge the focus to see the picture nationwide,
it is clear we must bake health equity into everything we do in public health.
I applaud the Community Preventive Services Task Force for considering the social determinants
of health among your nine priority topics for the next five years, and also
for forming a health equity work group last year.
Your commitment to prioritize reviews of interventions
that could potentially advance health equity is a critical part
of ensuring optimal health for all.
Thank you for the important work you do through The Community Guide.
You truly lead with science every day.
Communities across the nation rely on your evidence-based recommendations
for proven health interventions,
and I am grateful for your commitment to our nation's health.
Please know I am your partner in this work,
and I am eager to work with you in the years to come.