In 2023, Mandy Cohen, MD, MPH, became the 20th director of the Centers for Disease Control and Prevention. Before joining the nation’s top public health agency, Cohen was health secretary at the North Carolina Department of Health and Human Services, helping lead the state through the first years of the COVID-19 pandemic.
Cohen spoke with The Nation’s Health in March about the state of public health and her top priorities for 2024.
How would you define the state of public health in the U.S. today?
Public health is recovering, and we are building back up smarter and more effective than we’ve been in the past.
As the nation transitions out of the COVID-19 emergency, what are CDC’s priorities for preparing for the next pandemic threat?
First is making sure that we are ready to respond to any health threat. We want to make sure that we are rapidly responding, that we have the expertise and the visibility of the data that we need to identify a threat early — to prevent it if possible and contain it — and be able to provide commonsense information to protect everyone’s health.
We also have to continue to make investments in infrastructure. Data systems are important, but then you need the people to power those systems and do the work, not just at the federal level but at the state and local level as well. Eighty percent of the funding from CDC goes to our states and localities…and we need to keep that up to prepare for the next emergency.
Then we need to make sure we’re able to rapidly respond. And that will mean we need new authorities at CDC to make sure that we can be the response agency that the country needs and deserves. We need to have the tools at our disposal to move fast.
The 2021 American Rescue Act included billions of new funds for public health workforce and infrastructure. As of January, CDC had awarded more than $4 billion of it to health departments. How critical is this investment?
It’s really the first of its kind in terms of flexible funding so that different jurisdictions can really address their most pressing needs. It is recognizing that we need people power to protect this country and keep us safe.
And those are the investments we want to continue to articulate to our congressional partners. Just like we protect our electrical grid, we need to protect what makes our health system work, and that is our critical (public health) infrastructure and our people.
CDC data show the U.S. suicide rate hit a record high in 2022, with nearly 50,000 deaths. How is CDC working to address upstream factors that impact suicide risk?
This is a place where I think CDC is a really important team player. We have a lot of tools we can bring to bear to help in reducing suicide, but we have to work closely with other partners, whether that’s federal partners or mental health providers in states and localities.
We put out a guide for youth mental health in schools that’s specifically looking at preventive actions that folks can take for our teens, understanding that coming out of the pandemic, we are seeing strains on youth mental health.
We also support a comprehensive suicide prevention program in 24 locations across the country. We would love to see this expanded nationwide because this program’s been successful We’ve seen about a 10% reduction in suicide where these programs are running. And so the good news is that we’ve evaluated some best practices that we want to see spread.
Helping young families thrive is one of your priorities as CDC director. What makes this an important issue to you, and how is CDC trying to help?
Supporting young families is where CDC and public health work in prevention can really shine, right? It is getting upstream and figuring out how do we make sure folks have a healthy trajectory for their whole lives.
There’s a lot of ways in which lifelong patterns of health start for our young kids. But for us, supporting young families isn’t just about the kids. It’s about Mom and Dad, too, and making sure our caregivers are supported and we’re preventing their health from declining, whether it’s preventing diabetes, doing smoking cessation, preventing cancer. These are all important ways that we strengthen families.
The pandemic ushered in a new wave of health misinformation. How important is learning how to combat it to today’s public health work?
To combat misinformation, we in public health and we at CDC must be transparent. We have to be quick. We have to be clear. We have to be repetitive. I’ve been saying we have to “flood the zone.”
We have to be communicating more frequently and in a way that is absorbable, actionable and entertaining, even, to make sure that folks can hear those good messages and understand commonsense solutions.
As a public health leader, what are some of the biggest lessons learned or insights you gained during the COVID-19 pandemic?
I had the privilege of leading the COVID response for the state of North Carolina. I certainly learned a lot of lessons being the tip of the spear of that work.
Look, this isn’t about being perfect. Nothing goes perfect in a crisis. But we have learned that clear, timely communications are so critical to build and maintain trust.
It’s not just communicating the words — it’s also delivering the services, the operational excellence that accompanies those words. So if we say you should get vaccinated, then we in public health have to do everything we can to break down every barrier and improve access points to make sure vaccination is the easy choice for people.
The other important lesson is really about partnership. This is not something that CDC or public health can do alone in terms of protecting health and improving lives. This is 100% a partnership.
This interview was edited for style, clarity and length.
- Copyright The Nation’s Health, American Public Health Association