The Patchwork U.S. Public Health System

To engage further with online learners, we use short-form videos to introduce assigned readings. In this example, students are assigned to read “The Patchwork U.S. Public Health System” by the New England Journal of Medicine (2022) and listen to the accompanying podcast interview with one of the authors. The article opens with a real-world scenario - a food safety outbreak at a Baltimore summit that made over a dozen participants sick. Meant to illustrate the “patchwork” nature of the U.S. public health system, the example demonstrates how response varies by location and how the decentralized system operates across three fragmented levels (local, state, and federal) with different authorities, priorities, and structures. Professor Sue J. Goldie uses drawings and guided questions to prompt students to consider why the public health system is so decentralized and uneven and what the consequences of fragmentation are on system performance.

Editorial and Podcast reference: Wallace M, Sharfstein JM. The Patchwork U.S. Public Health System. The New England Journal of Medicine 2022; 386(1): 1-4.