#17 Rochelle Walensky: How can we fix American public health infrastructure?

Bio(un)ethical

In this episode, we speak with Dr. Rochelle Walensky, former director of the Centers for Disease Control and Prevention (CDC). We discuss the state of American public health infrastructure, the challenges it faces, and what we can do to improve it.

(00:00) Our introduction
(03:45) Interview begins
(09:32) Core challenges: Maintaining and growing the workforce
(18:41) Core challenges: Standardizing and modernizing data systems
(28:01) Core challenges: Reorganizing laboratory systems
(30:32) The problem of fragmentation
(44:55) Tradeoffs in communication; “following the science”
(52:57) Biggest lessons learned
(1:00:37) Public health infrastructure in the US vs. elsewhere
(1:07:34) Paths forward: public investment
(1:09:42) Paths forward: H5N1 and the scope of CDC’s authority
(1:15:32) Advice for aspiring public health professionals

Used or referenced:

• Lin et al., “A Single Mutation in Bovine Influenza H5N1 Hemagglutinin Switches Specificity to Human Receptors”
• Johns Hopkins, “Bird Flu is Raising Red Flags Among Health Officials”
• Walensky, “What I Need to Tell America Before I Leave the CDC”
• Berger and Walensky, “Reflecting on ACP’s Position Paper for Public Health: A View From the CDC Lens”
• Zhang et al., “Physician Workforce in the United States of America: Forecasting Nationwide Shortages”
• Harvard Chan School Department of Epidemiology, “The 175th Cutter Lecture on Preventive Medicine with Rochelle Walensky, December 8, 2023”
• Leonhardt, “Follow the Science?”
• Mann, “NPR Exclusive: US Overdose Deaths Plummet, Saving Thousands of Lives”
• Tin, “Obesity Rate in US Adults No Longer Growing, New CDC Data Suggests”
• CDC Moving Forward report
• (Howard Koh survey) Leider et al., “The Exodus of State and Local Public Health Employees: Separations Started Before and Continued Throughout”
• New England Journal of Medicine: Uyeki et al., “Highly Pathogenic Avian Influenza A(H5N1) Virus Infection in a Dairy Farm Worker”

Bio(un)ethical is a bioethics podcast written by Leah Pierson and Sophie Gibert, with editing and production by Ambedo Media (previous production support by Audiolift.co). Our music is written by Nina Khoury and performed by Social Skills. We are supported by a grant from Amplify Creative Grants.

Kapitel

1. Our introduction (00:00:00)

2. Interview begins (00:03:45)

3. Core challenges: Maintaining and growing the workforce (00:09:32)

4. Core challenges: Standardizing and modernizing data systems (00:18:41)

5. Core challenges: Reorganizing laboratory systems (00:28:01)

6. The problem of fragmentation (00:30:32)

7. Tradeoffs in communication; “following the science” (00:44:55)

8. Biggest lessons learned (00:52:57)

9. Public health infrastructure in the US vs. elsewhere (01:00:37)

10. Paths forward: public investment (01:07:34)

11. Paths forward: H5N1 and the scope of CDC’s authority (01:09:42)

12. Advice for aspiring public health professionals (01:15:32)