Who the Health Cares? with Prof Michael Sparer

Public health funding is often discussed as a matter of budgets and policy. But the real story is about politics, relationships and power. In the aftermath of the COVID-19 pandemic, states across the country received an unprecedented influx of federal dollars to strengthen their public health systems. But turning those investments into lasting change proved far more complicated than simply appropr...

Public health officials are navigating an increasingly complicated landscape defined by shrinking resources and political polarization. Meanwhile, artificial intelligence is transforming how health systems collect information, manage care and respond to community needs. The challenge for today’s public health leaders is figuring out how to adapt without losing the public’s trust or losing sight of...

The work of public health often becomes most visible when our systems are under the greatest strain. From hurricanes to pandemics, crises test not only our ability to respond, but also the strength, flexibility and fairness of the systems we rely on every day.  In this episode, Michael sits down with Mitch Stripling, Director of the New York City Preparedness and Recovery Institute, to discuss the...

The work of the U.S. public health system is invisible to many of us. That’s why public health guidance is often misunderstood – and ultimately mistrusted – by Americans on both sides of the political aisle. And in times of uncertainty, when clear guidance matters most, the gap between perception and reality is especially costly. In this episode, Michael speaks with Chelsea Cipriano, Managing Dire...

Getting public health messaging right isn’t easy. With trust in institutions on the decline and misinformation on the rise, even life-saving information often fails to reach the people who need it most. So what kinds of messages actually get through? In this episode, Michael sits down with Dr. Jide Williams, a neurologist and Vice Dean of Community Health at Columbia University. After watching str...

Medicaid was never intended to be the backbone of the U.S. public health system. But what started in 1965 as a limited health insurance option for a small group of low-income Americans has grown into a $900 billion program that funds everything from hospital care to housing support.  In this episode, Michael Sparer and Rebecca Sale trace the history of Medicaid and unpack the sweeping changes comi...

A health department in Kentucky pays half your rent. Another in Oregon runs the county jail's medical system. A third in Iowa partners with businesses to raise wages for childcare workers. How did we end up with a public health system where one department operates comprehensive medical clinics while another struggles to conduct timely septic inspections? Let’s investigate the 4 categories of work...

Why do public health departments have such little power, so few dollars, and are undervalued while their counterparts in the medical care system, especially physicians and hospitals, have influence, money, prestige, and respect There is no single or simple answer to these questions. But let’s start by looking back at three periods of American health care history: the emergence of the modern public...

When the Supreme Court in 2022 struck down President Biden's COVID vaccine mandate, it wasn't really about vaccines—it was about who has the constitutional power to issue such a mandate.  As it turns out, the 10th amendment gives states—and by extension, local governments— the "police power" to regulate and oversee our public health system. This is why we have 3,300 state and local health departme...

America has 3,300 local health departments. They are the backbone of our public health system, yet they are agencies most of us never think about. Until there's a crisis.  Join Michael Sparer from Columbia's Mailman School of Public Health as he explores how the US built this fragmented public health system, why it's struggling, and what we need to do to fix it. From Constitutional debates to garb...