CDC Quietly Changed Basis Of Essential Public Health Services From ‘Research’ To ‘Equity’

In a move that appears to have gone unnoticed, the Centers for Disease Control and Prevention updated its framework for how hospitals and other entities should carry “out the mission of public health.”

Developed in 1994, the original “10 Essential Public Health Services” framework included “research” in the center of a circle diagram with nine sections, indicating that research was an essential component to each branch of public health essentials. As the CDC explained, the public health system includes:

• Public health agencies at state and local levels
• Healthcare providers
• Public safety agencies
• Human service and charity organizations
• Education and youth development organizations
• Recreation and arts-related organizations
• Economic and philanthropic organizations
• Environmental agencies and organizations

The original framework listed 10 essential services:

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. Assure competent public and personal health care workforce
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services
10. Research for new insights and innovative solutions to health problems

But last year, those “essential” services were changed. Research no longer appears in the center of the circle, replaced by “equity.” The new essential public health services, according to the CDC, are:

1. Assess and monitor population health status, factors that influence health, and community needs and assets
2. Investigate, diagnose, and address health problems and hazards affecting the population
3. Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it
4. Strengthen, support, and mobilize communities and partnerships to improve health
5. Create, champion, and implement policies, plans, and laws that impact health
6. Utilize legal and regulatory actions designed to improve and protect the public’s health
7. Assure an effective system that enables equitable access to the individual services and care needed to be healthy
8. Build and support a diverse and skilled public health workforce
9. Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement
10. Build and maintain a strong organizational infrastructure for public health

The change to the 25-year-old framework gained little, if any, media attention, which is odd considering the focus on “equity” being launched in a year with months of race riots.

The new framework was released on September 9, 2020 and created by the Public Health National Center for Innovations and the de Beaumont Foundation, who put together a task force of “public health experts, leaders, and practitioners” to develop the new framework.

“The 10 Essential Public Health Services provide a framework for public health to protect and promote the health of all people in all communities. To achieve equity, the Essential Public Health Services actively promote policies, systems, and overall community conditions that enable optimal health for all and seek to remove systemic and structural barriers that have resulted in health inequities. Such barriers include poverty, racism, gender discrimination, ableism, and other forms of oppression. Everyone should have a fair and just opportunity to achieve optimal health and well-being,” the CDC says on its website regarding the change.

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