Our goal as public health advocates is to speak for health and demonstrate the importance of public health in our communities around the nation. The following sample questions are designed to help start conversations about public health issues with policymakers and candidates running for office at the federal, state and local levels.
These sample questions cover some of APHA’s advocacy priorities: increasing public health funding; supporting the Affordable Care Act and further expanding access to care; addressing the health impacts of climate change; protecting access to reproductive health care; gun violence prevention and research; and ensuring strong nutrition programs for children and in the reauthorization of the Farm Bill.
The questions should be tailored to highlight local issues by providing local examples, your area of interest or your expertise and concerns.
Note that the lists provided with certain questions are only examples and not exhaustive. Pick examples relevant to you and your community.
PUBLIC HEALTH FUNDING
I am concerned about the future of our state and local public health workforce because of the vital services they provide in our state and communities. These services include (Fill in with relevant services for your community — see list below for examples). Are you familiar with the public health programs that are funded by the Centers for Disease Control and Prevention and the Health Resources and Services Administration in (name of community/city/state)? Will you pledge to support increased funding for these chronically underfunded agencies and programs and oppose any future efforts to restrain or cut this important funding?
Examples to fill in above:
- Infectious disease detection and prevention
- Chronic disease prevention activities
- Public health workers including personnel at state and local health departments
- Public health laboratories
- Safety net for uninsured/assuring access to care
- Cancer screening
- Vaccine delivery programs
- Tobacco prevention programs
- Protecting the public from environmental toxins and other exposures
- Food safety
- Maternal and child health programs
The Centers for Disease Control and Prevention and the Health Resources and Services Administration fund programs that are critical to improving the public’s health. These agencies provide funding for programs like (Fill in with relevant programs for your community — see list below for examples). How can we reduce the economic and health-related costs of chronic and communicable disease and injuries when our nation is not investing in programs that prevent and treat these problems? Will you commit to working with your House and Senate colleagues to support vital increased funding for CDC and HRSA as Congress works to develop the FY 2024 Labor-HHS-Education appropriations bill which funds these important agencies?
Examples to fill in above:
- Access to care in rural communities
- Obesity and tobacco use prevention
- Infectious disease detection and response
- Emergency preparedness and response
- Health professions training and education
- Public health infrastructure
- Injury prevention
- Addressing the health impacts of climate change
- Social determinants of health
Our public health system and workforce is the first line of defense against the health threats that American communities face every day, yet the nation's public health infrastructure has long been underfunded. Unfortunately, in the past decade, state and local health departments lost 15% of essential staff and 80,000 more full-time equivalents – an increase of nearly 80% – are needed to provide a minimum package of public health services. Estimates suggest that at least 250,000 staff and around $4.5 billion annually are needed in the long-term to ensure that our nation’s public health system is as strong and resilient as necessary to respond to threats like the COVID-19 pandemic and to protect and promote health for all.
The Public Health Infrastructure Saves Lives Act would establish a Core Public Health Infrastructure Program at CDC to award grants to state, local, Tribal and territorial health to ensure they have the cross-cutting capabilities, tools and trained workforce to address existing and emerging health threats while also combating existing health disparities. Can I count on your support for this important legislation?
AFFORDABLE CARE ACT
The Affordable Care Act has helped millions of people gain affordable health coverage and is helping to shift our health care system from one that focuses on treating the sick to one that focuses on keeping people healthy. Unfortunately, in the past the ACA has come under attack by some in Congress, and there have been multiple attempts to repeal the law. Will you commit to working with your colleagues in a bipartisan manner to oppose any future efforts to weaken or repeal the Affordable Care Act and to support efforts to strengthen and expand the ACA to cover more of the nation’s uninsured population?
PREVENTION AND PUBLIC HEALTH FUND
It’s been said that an ounce of prevention is worth a pound of cure. The Prevention and Public Health Fund provides much-needed mandatory funding for programs at the local, state and federal levels to fight obesity, curb tobacco use, increase immunization rates, prevent childhood lead poisoning, increase access to preventive care services and help state and local governments respond to public health threats and outbreaks. Do you support maintaining funding for the prevention fund?
The Prevention and Public Health Fund was designed to increase the number of Americans who are healthy at every stage of life and has funded important programs to (Fill in with relevant examples — see list below for some options). Unfortunately, in the past Congress has passed legislation to cut or redirect the fund for unintended purposes – preventing the fund from growing to its originally intended level. Protecting the prevention fund from further cuts is essential to ensuring a strong and healthy nation by improving the public’s health and restraining the rate of growth in health care costs. Can I count on you take action to protect this important fund now and in the future?
Examples to fill in above:
- Promote tobacco-free living
- Encourage healthy eating
- Prevent childhood lead poisoning
- Detect and respond to infectious disease outbreaks
- Expand access to breast and cervical cancer screenings
- Prevent suicide
- Increase child immunization rates
- Prevent falls among older adults and adults with disabilities
CLIMATE CHANGE AND HEALTH
The fourth National Climate Assessment details the health impacts of climate change in the United States and notes, “The health and well-being of Americans are already affected by climate change, with the adverse health consequences projected to worsen with additional climate change. Climate change affects human health by altering exposures to heat waves, floods, droughts, and other extreme events; vector-borne, food-borne and water-borne infectious diseases; changes in the quality and safety of air, food, and water; and stresses to mental health and well-being.” Will you heed this clear scientific evidence and pledge to work with your colleagues to take steps now to reduce greenhouse gas emissions that drive climate change and harm health?
The responsibility to protect the public from the health threats of climate change will fall largely our nation’s state, local, territorial and tribal health departments. We need to invest additional resources in programs like CDC’s Climate and Health Program, which provides resources to health departments to prepare for and respond to the specific health impacts of climate change that threaten their communities. Will you support the $110 million provided for the program in the president’s FY 2024 budget proposal so that CDC can fund every state to develop plans to protect all of their communities from the health threats posed by climate change?
The Community Mental Wellness and Resilience Act of 2023 would create a grant program to fund local organizations and empower communities to prevent and heal mental health problems caused by all types of stressors and adversities, including climate change generated disasters and emergencies. Can I count on you to cosponsor this important legislation?
GUN VIOLENCE PREVENTION
In the final FY 2023 Labor-HHS-Education appropriations bill, Congress provided funding of $12.5 million each for CDC and the National Institutes of Health to conduct firearm injury and mortality prevention research. This year, I am urging Congress to increase this funding and provide NIH with $25 million, CDC with $35 million and the National Institute for Justice with $1 million for a total of $61 million, for this critical research. Can I count on your support for continued and increased funding for these agencies to conduct gun violence prevention research in FY 2024?
Gun violence is one of the nation’s leading preventable causes of death. In 2021, 47,286 individuals died as a result of gun violence, and thousands more suffered nonfatal injuries. After years of delay, it is time for Congress to act and take a comprehensive public health approach to addressing this growing crisis. Current law, which only requires background checks for guns purchased from federally licensed dealers, is inadequate and contains significant gaps that provide easy access to weapons for felons, domestic abusers, the seriously mentally ill and others prohibited from owning firearms. I support H.R. 715, the Bipartisan Background Checks Act, that would require a federal background check for all gun purchases, including those at gun shows, on the internet and through classified ads. Can I count on your support for this important legislation? Will you also support additional legislation to keep dangerous firearms out of the wrong hands?
ACCESS TO REPRODUCTIVE HEALTH SERVICES AND MATERNAL HEALTH
Last year’s Supreme Court decision in Dobbs v. Jackson Women’s Health Organization undid decades of Roe precedent and eliminated the federal right to abortion. As a result, people who can become pregnant are at risk of losing access to abortion in dozens of states that have passed legislation restricting and banning abortion. Will you commit to supporting legislation like the Women’s Health Protection Act (S.701/H.R.12) to codify the right to abortion at the federal level and protect against state-level attacks against reproductive health care?
The House FY 2024 Labor-HHS-Education spending bill, passed in subcommittee by the House Appropriations Committee, would zero out many essential programs like the Title X family planning program. Title X served 1.7 million people in 2021 and supports programs that reduce unintended pregnancy rates, limit transmission of sexually transmitted infections and increase early detection of breast and cervical cancer by increasing access to family planning and related preventive health services for adults and adolescents in communities across the country. Will you commit to supporting funding for the Title X program and other programs that support reproductive health in the FY 2024 appropriations process?
Maternal mortality is an ongoing public health crisis that affects all American women and pregnant people, but the situation is especially dire for Black women and other women of color; research shows that Black, Native American and Hispanic moms all face much higher rates of maternal mortality than white moms. The Black Maternal Health Momnibus Act of 2021 (S. 1606/H.R. 3305) would build on existing progress made in maternal health with provisions that would invest in social determinants of health, grow and support the perinatal workforce, improve data collection and promote maternal vaccination. Will you commit to supporting this bill and other efforts to combat maternal mortality and protect moms?
SUPPORT STRONG NUTRITION PROVISIONS IN CHILDREN'S NUTRITION REAUTHORIZATION AND THE FARM BILL
The Child Nutrition Reauthorization is due to be passed this year, which contains important programs impacting healthy food access for kids. One critical way that Congress can act to support access to healthy food for kids is by strengthening nutrition standards for school meals. Will you commit to support school meal standards that align with the Dietary Guidelines for Americans, which contains evidence-based recommendations about targets like sodium, whole grains, and added sugars?
The Farm Bill is due to be reauthorized this year, giving Congress a chance to make key updates to many nutrition programs that communities rely on, like the Supplemental Nutrition Assistance Program. SNAP helps millions of low-income Americans have access to healthy food. Will you commit to supporting a Farm Bill that protects the SNAP program and includes strengthened benefit levels for SNAP recipients?