An Underfunded Public Health Workforce Imperils Global Health

Stephanie L. Ferguson, PhD, RN, FAAN; Michelle A. Williams, ScD


Nurs Econ. 2021;39(5):251-254. 

In This Article

Abstract and Introduction


Underfunding of public health initiatives endangers people's health, safety, and well-being in the United States and across the globe. The promise and virtues of public and private partnerships, government and global agencies leading forward with evidence, and calls to action to strengthen public health infrastructure and enhance public health workforce capacity, particularly public health nursing, are reported.


Across the globe, COVID-19 continues to take its toll. Cases have surpassed 198 million, with more than 4 million deaths. In the United States, the highly contagious Delta variant is accelerating the pandemic, especially among younger, unvaccinated people. Even the fully vaccinated can become infected with Delta and spread the virus to others, as the Centers for Disease Control and Prevention (CDC, 2021) found in a recent study of breakthrough infections in Provincetown, MA (Brown et al., 2021). This revelation was a game-changer, reviving public debate about vaccines, mask mandates, and other prevention strategies. But missing from the conversation are significant, underlying factors in COVID's deadly spread: chronic underinvestment in public health infrastructure and public health workforce.

As the Trust for America's Health reports (TFAH, 2021), prolonged underfunding of public health systems severely undermined our country's COVID-19 response. The same is true in countries around the world. The factors involved in underfunding and recommendations to ensure investments in the public health sector and public health nursing are addressed.