JPHMP Direct

Sometimes public health feels like an alphabet soup of acronyms, frameworks, and jargon that only insiders can understand. While acronyms and jargon can be easily explained, the nuance between frameworks, whether subtle or stark, is hard to keep track of in a fast-paced and ever-changing world. We need a clear, consistent way to identify and apply the most relevant frameworks, understand how they work together, define effective practice, and measure progress toward excellence.

I have lived all of my life in Central Appalachia. Long before I had a Doctor of Public Health degree, I knew what health disparities looked like. I just didn’t call them health disparities. I knew what it looked like when someone waited too long to see a doctor because there wasn’t one nearby. I knew people who stretched medications, skipped appointments, drove ridiculous distances for healthcare, or simply went without. I knew families who had to decide which bill got paid that month.

For nearly six decades, Bill Keck has expanded the frontiers of public health practice with curiosity, courage, and an extraordinary capacity to bring people together. He has challenged conventional boundaries between medicine and public health, academia and practice, research and application, and national and international perspectives. More than once, he entered territory where few had gone before and then built a path for others to follow.

The landscape of healthcare in the United States has been shaped over decades of federal legislation and reform since the early 1900s. Last summer, the 2025 federal budget reconciliation act, better known as the One Big Beautiful Bill Act (OBBBA), was signed into law, introducing expansive changes to several federal agencies and programs, including health and social programs like Medicaid and SNAP.

An Epidemic of Mistrust The growing mistrust in public health might be the most important epidemic facing the field today. Trust in public health dropped during the COVID-19 pandemic, but it had already been eroding for decades. This erosion is part of a much broader decline in Americans’ confidence in institutions of all kinds. Public opinion data show that in 1958, nearly three-quarters of Americans trusted the federal government to do what is right most of the time.

With the launch of the Refreshed Standards & Measures (2026), much of the conversation has focused on what changed. And now that Version 2026 is in use, the more important question is: What do these updates mean in practice for health departments? The answer is simple.

Public health has spent the last several years talking about workforce shortages. And for good reasons, health departments and public health organizations across the country are facing vacancies, retirements, burnout, limited pipelines, and increased demand on staff who are already stretched thin. These challenges are real. They affect what public health agencies can do, how quickly they can respond, and how well they can sustain their work over time.

Introduction Collaborations between public health and healthcare organizations are common and may form for a variety of reasons, including to develop needs assessments, support emergency preparedness and response, and infectious disease response. In rural settings, these collaborations may look different from those in urban settings due to workforce shortages, resource scarcity, and other challenges faced by rural local health departments (LHDs).

Accreditation has the potential to advance and strengthen public health services, contributing to improved health outcomes and a more equitable public health system. PHAB offers a range of data that has been used in a variety of ways by researchers, students, health departments, policymakers, and public health partners. Interested in using PHAB data?

As my colleague Dr. Shafer mentioned in the first post, the recent interrogation of Dr. Anthony Fauci by the US senate was, in many ways, a travesty. It epitomized many of our current problems in America, including a belligerent ideology that attacks expertise and a broader backlash against public health and public health officials. However, it is important to unpack this situation if we are going to learn from it.