LGBT I Stand For Those Whose Families Do Not Accept Them Because Of Their Identities Shirt, hoodie, tank top
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LGBT I Stand For Those Whose Families Do Not Accept Them Because Of Their Identities Shirt, hoodie, tank top
The changes we need to make can be grouped into three broad categories. The first is disease surveillance. “We have no idea what’s out there,” Farzad Mostashari, a former assistant commissioner of New York City’s public-health department and the Obama Administration’s national coördinator of health information technology, told me. Health agencies must be able to identify and track outbreaks before they get out of control; to do so, they must collect viral samples and send them to local laboratories on a continuous basis. This requires funding, but, Mostashari said, it also demands an investment in the nation’s “public-health informatics” infrastructure. Mostashari cited his experience at New York City’s health department, from 2005 to 2009: he regularly handled fifty-nine separate data feeds—Word files, Excel files, CSV files, TXT files—from the city’s fifty-nine emergency departments, spending hours each week trying to make sense of it all. There have been improvements since then, but the basic problem persists. “What we need is a single national platform—a common set of tools—that brings in data from every state in an organized way,” he said. “There would still be local control and governance of the data, but it would be standardized and interoperable across the country.”
Funding for such a system must be not just substantial but long-term. After 9/11, hundreds of millions of dollars were sent to state and local health departments—but, Mostashari said, the money later dried up. “We need to think of public health like defense,” he said. “The systems we maintain during peacetime are the ones that allow us to succeed at war.” Mostashari told me that he thinks a set percentage of U.S. Health-care spending should be earmarked for public-health efforts. Sylvia Burwell, who ran the Department of Health and Human Services under President Barack Obama, concurred: she argued that the federal government should create a single strategy spanning every agency involved with public health. “This is about more than health,” she said. “It’s about our national security and our economic prosperity. We need to start acting like it.”
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