A 21st century national public health system

Abstract

The attention that SARS created in 2003 has influenced public and political perceptions about the risks associated with infectious diseases and the role the public health system should play in national security. This comparative case study was conducted to examine the Canadian public health's system response to SARS in order to formulate recommendations for the U.S. public health system. This analysis demonstrated that the governmental organizational structure of the U.S. public health system does not support its current mission or its new responsibilities for public health security. A national public health system is needed to support dual missions: the traditional mission of tailoring public health programs specific to the social and demographic needs of the citizens; and the new mission of public health security. In order to transform the current U.S. public health system into a national public health system two critical components must be addressed at the federal, state, and local level: 1) organizational capacity and 2) service delivery. Recommendations are provided regarding the way forward at the federal level and work needing to be done at the state and local level towards building a national system capable of meeting the public health threats of the 21st century.