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Being prepared and just

By: Ernest J. Grant, PhD, RN, FAAN, President, American Nurses Association

ANA calls for reinvesting in public health for all.

Every nurse, every person, should care about public health. Yet our society hasn’t treated it as a priority. Public health frequently is one of the first line items cut when governments need to reduce shortfalls or balance their budgets. As a result, its infrastructure and workforce have been fighting against a death by a thousand cuts over several decades. Since 2008 alone, health departments lost 55,000-plus staff positions because of funding reductions, and we’re paying a heavy price—some populations more than others. This has been made even more apparent during the pandemic and national protests over deep-rooted racism and social injustices.

The American Nurses Association (ANA) believes we must have a strong, well-funded public health infrastructure and workforce to ensure our nation has the capability to prepare and respond to the needs of communities, not only in times of crisis but also if we really want to make a difference in the overall health and well-being of all populations throughout the United States.

Public health nurses play an integral role in improving our nation’s health. They help track and prevent contagious diseases, conduct immunization clinics, and provide education and services to at-risk populations. They partner with key community leaders to assess and meet the unique needs of their communities, and as care providers, educators, and agents of change, they help narrow disparities and reduce chronic conditions and deaths from preventable diseases. During the COVID-19 pandemic, public health nurses have been crucial to monitoring cases, testing, and contact tracing.

These days it’s difficult to talk about public health without addressing the pandemic, social injustices, and their impact on minority populations. In my testimony to the House of Representatives Committee on Ways and Means, I shared some early data from Chicago and Milwaukee showing that over 70% of COVID-19–related deaths were among Black residents, even though they make up a considerably lower percentage of the population in both cities. Contributing to the disturbing number of COVID-19 cases among Black Americans and other people of color are long-standing social determinants of health that lead to anything but “health.”

These determinants include a lack of access to quality, culturally sensitive care; safe housing and playgrounds; and grocery stores with healthy food options. Another factor that must be explicitly called out and addressed is the systemic racism and discrimination that prevents us from having a health system—and nation—rooted in equality. I encourage you to view ANA’s free webinar on reducing racial disparities.

ANA is collaborating with public health nursing organizations to increase awareness and support for public health and to create crucial change. Advocacy at all levels of government is critical, and we need the voices of all nurses. ANA has a letter that you can send to your governor to ensure better preparation for subsequent emergencies and to address other public health priorities, such as ending HIV, preventing chronic illness, and building equitable prevention programs to close the health disparity gap.

Additionally, Congress must rebuild our public health workforce and infrastructure by reinvesting in community-based care and enhancing the Centers for Disease Control and Prevention’s ability to prepare and respond to healthcare crises. You can join us in our advocacy at

I ask you to challenge elected officials and other decision-makers to make public health and its funding a priority, and then hold them accountable on Election Day. Become more involved in your community or join boards that address public health issues, including health equity. And partner with ANA and your colleagues to eliminate systemic racism. Everyone—everyone—deserves to be healthy and safe.



Ernest J. Grant, PhD, RN, FAAN, President, American Nurses Association

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