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Who the Health Cares? with Prof Michael Sparer: Daily Summaries Delivered
by Center for Public Health Systems
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. They respond to disease outbreaks, inspect restaurants, ensure safe drinking water, and coordinate emergency responses. Yet their work remains invisible, their budgets are perpetually squeezed, and their authority is increasingly questioned. Host Michael Sparer traces how we built this fragmented public health infrastructure, from Constitutional debates to 1866 garbage collection to today's vaccine controversies. He examines why healthcare spending dwarfs public health investment, why public health agencies vary so dramatically from community to community, and why understanding this system matters for everyone. This isn't partisan politics. It's about the public health infrastructure that protects us every day. Who the health cares? We all should.
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- 3 days ago29 min
Why Public Health Is Inescapably Political With Professor Larry Brown
This week, Professor Sparer is joined by Columbia Mailman professor and political scientist Larry Brown for a conversation about whether public health can ever truly be separated from politics. They discuss why local leadership is essential to rebuilding public trust, the potential impact of the midterm elections, and what the next generation of public health professionals needs to know about navigating the political realities of their work.
- 2 weeks ago43 min
Former CDC Director Mandy Cohen on the Politics of Public Health
Welcome to season three of Who the Health Cares from the Center for Public Health Implementation at Columbia University. In this episode, Former CDC Director Dr. Mandy Cohen joins Professor Sparer to reflect on how the public health, healthcare, and social services sectors can work together more effectively. They explore lessons from Cohen's time leading the CDC and North Carolina's Health and Human Services agency, discuss the role of politics in public health policymaking, and consider how public health leaders can make a stronger case for their work. Read more about the Healthy Opportunities Pilot here.
- Jun 2, 202645 min
Public Health, Politics, and Money: Lessons from Kentucky and Indiana
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 appropriating money. In this episode, Michael trades places with guest host Rebecca Sale to discuss his ongoing research tracking public health funding in five states. Focusing on Kentucky and Indiana, Michael explains how coalitions of public health leaders, legislators, local officials and community partners helped secure major new investments in local health departments. He also explores why Kentucky's reforms have largely endured while Indiana's funding was dramatically reduced, and what these contrasting experiences reveal about the challenges of demonstrating value, maintaining political support and building a sustainable public health system. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.
- May 19, 202625 min
Former Health Secretary Umair Shah on AI, MAHA and Leadership Lessons
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 their core mission: improving the health of the communities they serve. In this episode, Michael speaks with Dr. Umair Shah, former Secretary of Health for Washington State and former executive director of the Harris County health department in Texas. Drawing on his experience at both the local and state levels, Umair explains how health departments are responding to workforce shortages, shifting federal priorities and the need to function as a safety net provider. He also discusses the growing role of AI in health care and why he believes public health can still serve as a unifying force in a divided country. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.
- May 5, 202632 min
How Decisions Get Made During Public Health Disasters
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 role of emergency preparedness and response within our public health system. Drawing on decades of experience responding to disasters across the country, Mitch explains how emergency response systems are supposed to work and why they sometimes fail. He also reflects on what the COVID-19 pandemic revealed about our leaders’ ability to respond under uncertainty and the risks and opportunities that come with emerging technologies like AI. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.
- Apr 21, 202630 min
Public Health, Lost in Translation
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 Director of the Common Health Coalition. Drawing on her experience at the federal, state and local levels, Chelsea explains how mixed messaging, pandemic-era missteps and a lack of clear storytelling have eroded trust in public health. She also highlights what leaders can do to rebuild trust and find new ways to fund the work that keeps communities healthy. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.
- Apr 7, 202630 min
Public Health Finds a New Beat
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 stroke patients arrive too late for effective treatment, Jide partnered with hip hop artist Doug E. Fresh to create a music-driven approach to stroke education. That effort grew into Hip Hop Public Health, a broader model that uses music and storytelling to teach kids about everything from healthy eating habits to the importance of cancer screenings. Jide also explains why music is such a powerful learning tool and what it takes for doctors to rebuild trust with the communities they serve. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.
- Mar 26, 202623 min
The Hidden Cost of Cutting Medicaid
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 coming to the program under the “One Big Beautiful Bill.” The result won’t just be fewer people with insurance. It could also mean unexpected and harmful cuts to the country’s already fragile public health system. They also discuss whether a small, unexpected provision for rural health investment could point toward a better model for the future. Michael S. Sparer, J.D., Ph.D. is the William Henry Welch Professor of Public Health Systems at Columbia University's Mailman School of Public Health, where he has taught for over 30 years. He also directs the Center for Public Health Systems, which examines how America's fragmented public health infrastructure functions and how it can better serve communities. Professor Sparer’s research examines how policy shapes politics both in health insurance systems and in local health departments. He is particularly expert in Medicaid policy and in the inter-governmental dynamics that have shaped the evolution of that program. His work on public health has also focused on federalism and on the ways in which local health departments respond to changing political and fiscal environments. Before his academic career, he spent seven years as a litigator for the New York City Law Department. He is a three-time recipient of Columbia teaching excellence awards and former editor of the Journal of Health Politics, Policy and Law. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals, and provides educational programs, all with the goal of encouraging a better, more efficient, and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid, and under-valued and that a stabilized and strengthened system would benefit all of us.
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About Who the Health Cares? with Prof Michael Sparer
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. They respond to disease outbreaks, inspect restaurants, ensure safe drinking water, and coordinate emergency responses. Yet their work remains invisible, their budgets are perpetually squeezed, and their authority is increasingly questioned. Host Michael Sparer traces how we built this fragmented public health infrastructure, from Constitutional debates to 1866 garbage collection to today's vaccine controversies. He examines why healthcare spending dwarfs public health investment, why public health agencies vary so dramatically from community to community, and why understanding this system matters for everyone. This isn't partisan politics. It's about the public health infrastructure that protects us every day. Who the health cares? We all should.
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