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Public Health Infrastructure

Public Health Infrastructure


To ensure that Federal, State, Tribal, and local health agencies have the necessary infrastructure to effectively provide essential public health services.


Public health infrastructure is fundamental to the provision and execution of public health services at all levels. A strong infrastructure provides the capacity to prepare for and respond to both acute (emergency) and chronic (ongoing) threats to the Nation’s health. Infrastructure is the foundation for planning, delivering, and evaluating public health.

Why Is Public Health Infrastructure Important?

Public health infrastructure includes 3 key components that enable a public health organization at the Federal, Tribal, State, or local level to deliver public health services. These components are:

  • A capable and qualified workforce
  • Up-to-date data and information systems
  • Public health agencies capable of assessing and responding to public health needs

These components are necessary to fulfill the following 10 Essential Public Health Services:1

  1. Monitor health status to identify and solve community health problems.
  2. Diagnose and investigate health problems and health hazards in the community.
  3. Inform, educate, and empower people about health issues.
  4. Mobilize community partnerships and action to identify and solve health problems.
  5. Develop policies and plans that support individual and community health efforts.
  6. Enforce laws and regulations that protect health and ensure safety.
  7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
  8. Ensure competent public and personal health care workforces.
  9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
  10. Research for new insights and innovative solutions to health problems.

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Understanding Public Health Infrastructure

Public Health Infrastructure is key to all other topic areas in Healthy People 2020. It allows for and supports key goals of Healthy People, including the:

  • Improvement of health
  • Creation of environments that promote good health
  • Promotion of healthy development and behaviors

Public health infrastructure, along with the 10 essential functions of public health, influences—and is influenced by—a number of factors, including the social and political environment. As such, public health infrastructure provides a useful framework for addressing the social determinants of health.

Emerging Issues in Public Health Infrastructure

Increasing attention to public health infrastructure has led to the identification of a number of emerging issues.

Tribal Public Health Infrastructure

Each Tribe is an independent government that must adopt local strategies to meet its public health challenges; interventions must be tailored to the cultural beliefs and practices of each Tribe. There are many ways Tribal entities are served through the Indian Health Service, Tribal Epidemiology Centers, and national organizations; however, challenges remain.

Disparities in the Public Health Workforce

As minority populations in the United States increase, the country will need a more diverse public health workforce. Hispanics, American Indians and Alaska Natives, and African Americans are underrepresented in the public health workforce.

Accreditation of Public Health Agencies

In an effort to standardize services and improve performance, public health agencies are moving toward a voluntary national accreditation program. This program will highlight agencies’ commitment to service and quality and provide a standard toward which all public health agencies can work.

Public Health Systems Research

Expanding the evidence base for community interventions and for the effective organization, administration, and financing of public health services is critical to the future development of public health infrastructure. The emerging field of public health systems and services research is playing an important role in the development of this evidence base; its role should be supported and expanded over the decade, with a strong focus on translating research into practice.

Public Health Law

Novel policies are being developed to address legal and political challenges resulting from new and re-emerging infectious diseases and increasing levels of chronic disease. New centers devoted to the study of public health law are adding to the body of knowledge in this critical area.


1US Department of Health and Human Services, Centers for Disease Control and Prevention, Core Public Health Functions Steering Committee. National public health performance standards program: Orientation to the essential public health services [slides]. 1994.

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