Letter from the Executive Director

Looking back on 2023, I am struck by what an important transition year this has been for our members, the leaders of 35 of the largest urban health departments in the U.S. Having exited the public health emergency of 2020–22, big city health departments continue to deal with COVID and other respiratory diseases but have also shifted their focus back to ongoing public health issues – drug overdose, gun violence, tobacco use, maternal and infant health, and the many ways racial disparities crosscut these issues – as well as (re-) emerging threats such as measles.

As the pandemic fades into the rearview mirror and the emergency funding disappears, the question becomes: will we finally interrupt the boom-and-bust cycle and invest sustainably and predictably in governmental public health so that we are prepared not just for the next emergency but also for the crises we are facing right now?

The answer is decidedly mixed. On the one hand, the investment in late 2022 from the U.S. Centers for Disease Control and Prevention (CDC), known as the Public Health Infrastructure Grants (PHIG), offered an important ray of hope. These grants are not tied to a single disease or emergency but instead recognize that protecting the public’s health requires a cross-disciplinary shot in the arm to the public health workforce and infrastructure, including a major investment in data modernization. On the other hand, these funds are a long overdue down payment, and while the dollars are doing important work, they are time-limited and there is a very real funding “cliff” coming in years to come. Until we commit to sustained, predictable funding for our governmental public health system, our nation’s health remains at risk.  

In recognition of this pivotal moment in our field’s history, in 2023 we doubled the size of the BCHC staff to seven and increased our revenue by about a third. These increased resources allow us to better support our members’ changing needs and engage with additional leaders in our members’ health departments. Generous support from our funders has made this possible.

In closing, I thank our members for the work they do every day to protect and promote health in their communities and feel so very privileged to be able to learn from them and tell their stories to others.

Chrissie Juliano, MPP
Executive Director