The Future of Public Health: Ensuring An Adequate Infrastructure

Centennial Issue Public Health

Policy Points:

  • The US public heath infrastructure is in disrepair and building a sustainable system is the central challenge for the nation.
  • Doing so in a highly patrician environment is the mission for the next ten years.

The public health infrastructure in the United States is in disrepair. In fact, it has never truly been adequate to meet the needs of the nation and our nation’s role in global affairs. In 1988 the Institute of Medicine of the National Academies of Sciences published the results of a consensus study entitled “The Future of Public Health.”1 This report found the nation’s public health system to be in disarray and that the nation had lost sight of its public health needs. Since that time the nation has struggled to address this finding and to build a system that can adequately address the ever-growing needs of the population. Infrastructure is defined as “the resources (such as personnel, buildings, or equipment) required for an activity.”2 In fact, there is growing evidence that the basic infrastructure of the public health system in the nation has continued to erode to the point that its capacity and capabilities to adequately protect the nation are in doubt.1

Open Access


  1. The Institute of Medicine. The Future of Public Health. National Academy Press; 1988
  2. Merriam-Webster. Definition of infrastructure. Accessed April 7, 2022

Benjamin GC. Future of Public Health: Ensuring An Adequate Infrastructure. Milbank Q. 2023;101(S1):637-652.