Iris R. Shannon, Ph.D., R.N. APHA President, 1989

Supporting the Public Health Infrastructure

Recently, infrastructure has been characterized as the nerve center of public health. For a variety of reasons, I believe that the problems associated with public health infrastructure are recalcitrant. Infrastructure issues have been persistent a long time and they seem to be resistant to change.

I would like to comment on only two of many factors contributing to this resistant state:

1. Human resource component: There is a significant need to strengthen public health teams by adding members with appropriate social-service and political-science expertise. Such skills are needed to confront the increasing numbers of recognizable health consequences associated with social problems and the need for effective communication with policy leaders.

2. Organizational resources: There is increasing interest in formulating partnerships for health and in other formal and informal collaborative arrangements, whether they be networks, coalitions, task forces, or committees. They usually involve the public and private sectors and provide ways of sharing responsibility and accountability for improving community health outcomes. A particular public health infrastructure challenge occurs where conflicting and competing interests among population groups emerge and that must be resolved. Whether collaborative effort results in societal support for public health greatly depends on successful resolution of issues and successful interorganizational dynamics.

I believe very firmly, with APHA’s emphasis on infrastructure, that we will be able to reverse this situation – that we will be able to make an impact, a very positive impact on infrastructure issues. I leave it to the leaders of the Association to bring forth the direction necessary to make it happen.

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