If you are familiar with the history of the Essential Public Health Services (EPHS), you know that the EPHS were originally drafted 25 years ago. While the revision of the essential services began in 2019, pre-COVID-19, the release of the revised EPHS could not be timelier.

During the reveal of the newly revised EPHS in a live video conference on September 9, 2020, many leaders in the field of public health shared about what value the revised essential services would provide to all levels of public health, especially considering the various challenges facing public health right now. You can watch the full video here.

What value will the revised EPHS provide to local public health departments?

They will:

  • Represent to stakeholders, elected officials, and community members what is happening on the ground in local health departments
  • Inform strategic planning for local health departments
  • Address the health needs of every member of every community by being more centered on health equity
  • Be more actionable and practical for public health practice, specifically by:
    • Focusing on policies, laws, and regulatory actions that are a key part of what public health does, and how to create, champion, and implement them
    • Focusing on building a strong public health infrastructure

During the live presentation revealing the revised EPHS, Chrissie Juliano, MPP, Executive Director of the Big Cities Health Coalition shared how COVID-19, as well as many other things public health has faced this year, have shown that when public health doesn’t build the needed infrastructure first and, instead, focuses on all the other things that must be done, there is a real challenge in actually being able to do all of those other things that must be done.

What value will the revised EPHS provide to tribal health departments?

Joe Finkbonner, RPH, MHA, Former Executive Director of the Northwest Portland Area Indian Health Board noted that many tribes currently have integrated public health and medical services. Therefore, the value can be found in distinguishing which services fall under public health and providing a framework for how to accomplish them.

This is valuable to both:

  1. Tribes considering public health accreditation
  2. Tribes considering separating out their public health into its own department

What value will the revised EPHS hold for state health departments?

State health departments often function in the role of overseer for city and county health departments. As such, state health departments can view the larger picture of what is happening in the health of the state as a whole, as well as create goals for the state’s health. In addition, state health departments are responsible for ensuring their state is working with other states towards reaching national public health goals as well as creating a platform for public health to be heard, valued, and understood at a national level.

The revised essential services give state health departments a means of accomplishing these tasks by:

  • Providing a framework for eliminating racism and working towards health equity.
  • Creating common goals and language for public health across the nation to share.
  • Providing a means of assessing public health infrastructure and capacity.

As Mike Fraser, PHD, CAE, Chief Executive Officer of the Association of State and Territorial Health Offices (ASTHO) shared during the EPHS reveal, there is more focus on infrastructure now. Although the revision of the EPHS began pre-COVID-19, now, after seeing public health in action during a global pandemic, public health leaders can look at and assess what worked, where more infrastructure or capacity or resources are needed, and what needs to happen to move forward.

What is the value of the revised EPHS for public health as a whole?

They:

  • Provide a means of protecting public health and its functions by showing what public health does. This is vital to advocating for resources, funding, and staffing.

“Our local health departments are currently facing some of the most challenging times in their history. They’re underfunded, they’re overworked, they’re understaffed and overwhelmed. The revised 10 Essential Public Health Services framework is really coming at a time – unplanned, but quite fortuitous – when we must stand up and protect public health and its essential functions. …As the current pandemic has made all the more clear, the role of local health departments to provide these services is vital, literally, as the historical un-investment in governmental public health has really compromised the nation’s ability to contain and prevent [COVID-19] and to build community resilience for future challenges. Any tool that helps us drive home the work that is done at the community level and across the governmental public health system is really going to be useful at this particular moment in time and into the future.” – Lori Tremmel Freeman, MBA, Chief Executive Officer, National Association of County and City Health Officials (NACCHO)

“Our local health departments are currently facing some of the most challenging times in their history. They’re underfunded, they’re overworked, they’re understaffed and overwhelmed. The revised 10 Essential Public Health Services framework is really coming at a time – unplanned, but quite fortuitous – when we must stand up and protect public health and its essential functions.” — Lori Tremmel Freeman, MBA, CEO, NACCHO

  • More accurately reflect current public health practice as well as the future of public health.

  • Are not so drastically changed as to cause the old EPHS to lose their meaning. The old EPHS still translate towards the new EPHS; this is important because:

    • Some states have incorporated the EPHS into laws or health systems
    • Many health departments have used the EPHS to pursue health accreditation

  • Can be used by roles at every level in public health. For example:

    • Academia (e.g. teachers and professors) can employ the essential services by:
      • Ensuring students do not graduate without having seen the 10 EPHS.
      • Helping students understand how to implement the EPHS in practice.
    • Practitioners can employ the essential services in:
      • Performance planning
      • Writing job descriptions for local public health department roles
      • Assessing current services and creating goals
    • Policy Makers can employ the essential services in:
      • Advocating for public health resources, funding, and capacity
      • Telling the public health story

“I think that’s always been the intent of the 10 essential services: to better tell the public health story and this revision gives us some new opportunity to do that.” – Mike Fraser, PHD, CAE, Chief Executive Officer, Association of State and Territorial Health Offices (ASTHO)

“I think that’s always been the intent of the 10 essential services: to better tell the public health story and this revision gives us some new opportunity to do that.” — Mike Fraser, PHD, CAE, CEO, ASTHO

  • Provide a common goal which will help all levels of public health attain outcomes more quickly

In Conclusion:

The revised 10 Essential Public Health Services provide value at every level of public health service and across the continuum of public health, but the value lies in their use. It is crucial that public health workers familiarize themselves with the new essential services and use them in order to give public health a voice, communicate clearly what public health is doing and why it is valuable, and provide better outcomes across the entire public health field.

“The responsibility now is to use them. You know, use these 10 essential services. Make it not a framework that sits on a shelf, but something that you keep with you, that guides your work. That helps you really guide our public health activities. Right now, we’re in the midst of a global pandemic and a racial reckoning that we would not have expected, even six months ago. So, there is an amazing opportunity for public health right now to really do what we all got into this business to do, which is change the world. But you only can do that if you are thoughtful and you are focused and if you help use these 10 essential services to guide our work. If we are working together on the same framework, we will get better outcomes more quickly, and that’s what we want. We want change, we want more equality, we want better health outcomes, and we’re going to do that together. And the 10 essential services, newly refreshed, is that platform on which we can all come together and move the health of our nation forward.” – Brian C. Castrucci, DRPH, MA, President & Chief Executive Officer of the de Beaumont Foundation

“Right now, we’re in the midst of a global pandemic and a racial reckoning that we would not have expected, even six months ago. So, there is an amazing opportunity for public health right now to really do what we all got into this business to do, which is change the world. …And the 10 essential services, newly refreshed, is that platform on which we can all come together and move the health of our nation forward.” — Brian C. Castrucci, DRPH, MA, President & CEO, de Beaumont Foundation

Read Next:

We will be publishing a series of articles about the revised Essential Public Health Services. Once published, links will be posted below, as well as on our social media. You can access the revised EPHS toolkit on the Public Health National Center for Innovations (PHNCI) website.