Public health officials stress that multi-state collaborations have always been essential to effectively control outbreaks, noting “disease doesn’t stop at any border.” (Photo by Scott Housley/Centers for Disease Control and Prevention)
New Jersey is among a growing number of states nationwide that have chosen to form regional collaboratives to share public health expertise and resources in the wake of changes at the federal Centers for Disease Control and Prevention, which has traditionally provided these services.
What is the Northeast Public Health Collaborative?
New Jersey last year teamed up with northeast states and cities as the Northeast Public Health Collaborative, along with Connecticut, Maine, Massachusetts, New York State and city, and Pennsylvania. Eventually, Delaware, Maryland, and Vermont also signed on and participants said it continues to grow.
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A trio of west-coast states have formed a similar group.
The northeast’s coalition doesn’t have a website or public face. Those involved said it exists to help track and respond to emerging public health threats, share expertise, and collaborate on policies that have regional impact, whether it’s tracking a disease outbreak or preparing for events like the World Cup final in East Rutherford later this year, which will bring together teams and fans from around the world — and could serve as a super-spreader event for infectious disease.
How does it function?
The regional government coalition includes roughly 200 representatives from the public entities involved, which are organized in standing workgroups focused on key areas like vaccine policy, lab capacity, data collection, and public communication, plus a group for senior leaders. Ad hoc groups can be added as needed, with additional experts pulled from the various states.
While the early collaborators met in person last summer in Rhode Island, the workgroups have continued to meet by phone or video call on a regular basis multiple times a month. There is no single spokesperson for the group, and participants can only speak for their city or state, not for each other.
“Fostering strong partnerships with our peers in the Northeast Public Health Collaborative builds a more resilient public health ecosystem that serves all of our residents. This regional alignment allows us to enhance preparedness and respond more effectively to the most pressing public health challenges impacting our communities. Simply put, it’s public health in action,” said Dalya Ewais, communications director for the state Department of Health, in an email to New Jersey Monitor.
What triggered its formation?
Public health officials stress that multi-state collaborations have always been essential to effectively control outbreaks, noting “disease doesn’t stop at any border.” But the timing of the northeast collaborative also seeks to fill what many see as a vacuum left in the wake of changes at the federal CDC, which traditionally served as a backstop to local offices, offering help with both expertise and workforce needs.
Under Health and Human Service Secretary Robert F. Kennedy Jr, a longtime vaccine critic who oversees work at the CDC, the agency has weakened its stance on immunization and other public health responses in ways clinical experts say is dangerous. As these changes began to take effect — like Kennedy’s overhaul of a vaccine advisory panel that had long been used to shape local and state immunization policies — many states, most led by Democrats, began to look elsewhere for expert guidance.
Chrissie Juliano, executive director of the Big Cities Health Coalition, an alliance of public health leaders that advocates for resources and policy solutions, told the New Jersey Monitor that it’s not realistic to think that more than 3,000 local health departments and roughly 60 state and territorial health departments nationwide would know everything about anything that comes up, whether it’s guidance on an infectious disease like measles or an environmental hazard like lead pollution.
“And so, the system we have been in, looks to places like the CDC or some of that expertise,” she said. “That, in some ways, has gone away.”
In addition to expertise, the CDC also provided staff to help small local health offices respond in a crisis. Juliano said when Milwaukee discovered elevated levels of lead in its schools last year it sought assistance from Washington, D.C., but she said the CDC representative assigned to help the city was laid off before he could start work in the community.
What led New Jersey to join?
Given the shift at the federal level, New Jersey set up an inter-agency work group in August to “minimize interruptions to vaccine availability and coverage,” state officials said recently about a law that codified changes recommended by this group.
New Jersey officials have used the state’s public messaging to push back on federal guidance they questioned, like when the federal government changed its vaccine recommendations in ways public health leaders said would leave people needlessly at risk. The state increasingly looked to professional organizations, like the American Academy of Family Physicians, for guidance in decision making.
In early September, California, Oregon, and Washington announced a West Coast public health alliance, pledging to “uphold scientific integrity in public health as Trump destroys CDC’s credibility.” By the end of that month, members of the northeast states announced their own plans to collaborate.
Juliano said the new arrangements are unlikely to attract much public notice, adding that states and localities should be collaborating anyway and “there’s too much work and not enough money to go around.”
“Our entire public health system depends on every different level of government working together — ideally working well together,” Juliano said. “And unless and until folks do collaborate, it makes everybody’s job harder and really doesn’t help the public to live healthier lives.”
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