In December 2020, just nine months after COVID-19 was declared a pandemic, public health officials began rolling out vaccines against the disease in the U.S. By summer 2021, 67% of adults had received at least one dose, and at least 240,000 deaths and over 1 million hospitalizations from the disease had been averted.
That success would not have been possible without a well-developed vaccine distribution system and multisector strategy that boosted uptake, according to Michael Fraser, PhD, MS, former CEO of the Association of State and Territorial Health Officials. Federal, state and local governments worked in tandem to open vaccine centers in rural, urban and underrepresented areas, Fraser notes in his new APHA Press primer, “Systems and Strategic Thinking.”
“A systems approach to COVID required quickly mapping out all the parts of the COVID response system, examining the interplay of public health and many other sectors, and leveraging interventions where we could have the most impact on preventing infections,” Fraser said in the new book, which was released in summer. “At the core of the systems and strategic thinking skill is an understanding of the need to approach problems and solutions from a broad, big-picture perspective.”
Understanding a system — why a problem exists — must be combined with a clear strategy to develop effective solutions, according to Fraser, who is now CEO of the College of American Pathologists.
“Systems and Strategic Thinking,” part of the Strategic Skills for Public Health Practice Series edited by Fraser and Brian Castrucci, DrPH, is a concise primer on how public health professionals can turn ideas into policies and successful programs. The approach involves looking closely at systems and structures that create health inequities and harm health outcomes.
Among those inequalities is the nation’s high rates of mortality for Black infants, who die at nearly double the rate of the national average. A complex network of relationships involving families, communities, health care facilities, socioeconomic status, hospital protocols, racism and more contribute to the problem.
Understanding the “system” that has created high Black infant mortality “can identify where there are points for improvement that could lead to better infant health outcomes,” Fraser said in the new book. From there, an evidence-based strategy can develop.
A systems approach opens pathways to engaging multiple sectors in solving problems, something shown in the COVID-19 vaccine rollout, Fraser said.
Case studies are sprinkled throughout the book to illustrate successful integration of a systems and strategic approach. One involves Iowa’s Lee County Health Department, which identified lack of child care availability and affordability for disadvantaged families as a reason for high unemployment in the county.
Fraser will be one of many APHA Press authors signing books during APHA’s 2024 Annual Meeting and Expo in Minneapolis on Sunday, Oct. 27. For the full signing schedule, see Page 15 of this issue.
To purchase “Systems and Strategic Thinking,” which is also available as an e-book, visit www.aphabookstore.org.
- Copyright The Nation’s Health, American Public Health Association
