Though health disparities persist in most countries, many people living in developed regions have taken for granted the ability to control disease outbreaks, access to safe food, clean water, and healthy homes, and reliable sanitation. This consideration combined with fewer severe pandemics in recent years has contributed to reduced investments in public health systems. This pattern has resulted in system weaknesses and vulnerabilities, which have been highlighted by COVID-19. There is now an urgent need to revitalize public health in general and environmental public health in particular to recover from COVID-19 and beyond. An essential part of building back better now and in the future is strengthening and supporting the environmental public health workforce around the world. These professionals are a backbone of public health systems, monitoring and addressing health hazards in the community and enabling society to function. They are responsible for delivering the 10 Essential Environmental Public Health Services to ensure community health that matters to us all (www.cdc.gov/nceh/ehs/10-essential-services/index.html). These colleagues are unsung heroes in local communities, standing on the front lines of routine public health efforts and responding when disasters and pandemics occur. Even though environmental public health is one of the largest parts of the public health workforce, the work of these colleagues routinely goes unnoticed until bad things happen and stories of contaminated drinking water supplies, food-borne illness outbreaks, vector-borne diseases, or natural or anthropogenic disasters appear in the media. Despite this reality, professionals in the field were not consistently considered as essential workers by many decision makers before and during the COVID-19 pandemic. Recognizing the many challenges facing environmental public health in the United States, and prior to COVID-19, the Centers for Disease Control and Prevention launched the UNCOVER-EH (www.cdc.gov/nceh/ehs/uncover-eh/index.html) initiative to better understand the demands on environmental public health professionals. This effort included examining the needs, challenges, and opportunities facing the profession. Unfortunately, an exercise of related scope in the United States was last performed in the early 1960s for this fundamental backbone of public health. Similar scoped efforts have not yet occurred in other countries. Although UNCOVER-EH focused on the United States, it is already making differences that matter and could provide a useful template for other regions to consider. Findings from UNCOVER-EH identify key opportunities for expanding partnerships and research activities. Enhancing nontraditional partnerships is necessary, because the public health system is fractured across the United States, resulting in inefficiencies and inequity in delivery of health programs among communities in states, tribes, and territories. More than a year ago, launching a national scale research initiative was recommended to address priority challenges to the practice of environmental public health and associated research needs (https://ehp.niehs.nih.gov/doi/10.1289/EHP5161). This timely and important effort promises to improve translation of basic science discoveries for routine and emerging health threats. It will stimulate innovation, improve the health of local communities, increase our return on investment in public health, and is vital to building back better. Observations from UNCOVER-EH are also sobering on professional recruitment and training in this field. Most environmental public health professionals are responsible for delivering a number of different programs, which are vital for society to function. Some of these include outbreak control, sanitation, drinking water, food safety, vector control, hazardous waste management, and support of mass gatherings. They must be problem solvers and generalists, often taking on new threats when they appear in a community. Yet 26% of these professionals are expected to retire in 5 years, at a time when only 6% of public health students are pursing this training. This essential segment of the public health workforce appears to be overworked, understaffed, and aging. In fact, retaining and recruiting qualified staff were ranked as the two most important professional priorities in the United States as part of UNCOVER-EH (Table 1). www.cdc.gov/nceh/ehs/uncover-eh/index.html. We need to increase the number of undergraduates and graduate students specializing in environmental public health across the globe. Expanded training and requiring credentials such as the Registered Environmental Health Specialist in the United States (www.neha.org/professional-development/credentials/rehsrs-credential) or Charted Status in the United Kingdom (https://www.cieh.org/membership/chartered-status/) can improve the preparedness of the current workforce. As part of UNCOVER-EH, creation of a new national training program to enhance the preparedness of the environmental public health workforce was specifically recommended (https://ehp.niehs.nih.gov/doi/10.1289/EHP5161). And then COVID-19 happened. Our colleagues around the world answered the call in response to the pandemic. They have served in incident command centers, performed contact tracing, and facilitated vaccination roll out, all while trying to maintain their everyday work of keeping our food, air, water, and communities safe. Environmental public health professionals are tired and have been stretched thin (https://www.neha.org/sites/default/files/flipping_book/neha-covid-19-eh-workforce-needs-assessment-ii-report/). Despite some countries currently experiencing a downturn in COVID-19 cases, the pandemic persists in others, new strains of the virus are emerging, and it continues to present considerable stress on health care systems. Strain on public health professionals has been palpable. In the United States, for example, staff have resigned due to burnout, political pressure, and even death threats. An overworked, understaffed, and aging workforce needs our help. We need to revitalize the environmental public health workforce. Now, more than ever, environmental public health matters. In the United States, a new administration brings renewed hope and welcomed opportunities to redouble our efforts in the fight against COVID-19. We must also address environmental public health disparities and environental justice issues while bolstering efforts to engage the complex, multifaceted threats of climate change. President Biden recently issued an executive order to establish a COVID-19 Pandemic Testing Board and to ensure a sustainable public health workforce for COVID-19 and other biological threats. This executive order specifically identifies creation of the U.S. Public Health Job Corps. In addition to bolstering training of public health workers to support testing, vaccination, and contact tracing, the order identifies “other urgent public workforce needs”. The order further indicates the U.S. Public Health Job Corps will provide “other necessary services to Americans affected by the COVID-19 pandemic”. Timely workforce recommendations from UNCOVER-EH (https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2019.305441) combined with the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 provide pathways to support these essential activities now and in the future. Bolstering and ensuring a sustainable environmental public health workforce is timely, urgent, and necessary. There is the evidence, need, and a once-in-a-generation opportunity to build back better. We must commit to more effectively, efficiently, and equitably delivering the essential environmental public health services to local communities in response to COVID-19 and beyond. Now is the time to revitalize environmental public health in the United States; doing so may provide a useful template for other regions around the world with a similar situation. Our health depends on it, as we enhance our fight against the current pandemic and prepare for threats to come. Views expressed in this editorial are those of the authors and not necessarily the views of the ACS. Views expressed in this editorial are those of the authors and not necessarily the views of the ACS.
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更好地建设环境公共卫生

尽管大多数国家的健康差距持续存在，但生活在发达地区的许多人已将控制疾病爆发的能力、获得安全食品、清洁水和健康家园以及可靠的卫生设施视为理所当然。这种考虑加上近年来严重流行病的减少，导致对公共卫生系统的投资减少。这种模式导致了系统弱点和漏洞，这在 COVID-19 中得到了强调。现在迫切需要重振一般公共卫生，特别是环境公共卫生，以从 COVID-19 及以后的情况中恢复过来。现在和未来重建得更好的一个重要部分是加强和支持世界各地的环境公共卫生工作人员。这些专业人员是公共卫生系统的支柱，监测和解决社区中的健康危害并使社会能够正常运转。他们负责提供 10 项基本环境公共卫生服务，以确保对我们所有人都很重要的社区健康 (www.cdc.gov/nceh/ehs/10-essential-services/index.html)。这些同事是当地社区的无名英雄，站在日常公共卫生工作的第一线，在发生灾害和流行病时做出反应。尽管环境公共卫生是公共卫生人力中最大的组成部分之一，但这些同事的工作通常会被忽视，直到坏事发生以及饮用水供应受污染、食源性疾病暴发、媒介传播疾病或自然或人为灾难出现在媒体上。尽管有这样的现实，在 COVID-19 大流行之前和期间，许多决策者并未始终将该领域的专业人员视为必不可少的工作人员。认识到美国环境公共卫生面临的许多挑战，在 COVID-19 之前，疾病控制和预防中心启动了 UNCOVER-EH (www.cdc.gov/nceh/ehs/uncover-eh/index.html ) 倡议以更好地了解对环境公共卫生专业人员的需求。这项工作包括检查该行业面临的需求、挑战和机遇。不幸的是，美国上一次在 1960 年代初对这一公共卫生的基本支柱进行了相关范围的练习。其他国家尚未进行类似范围的努力。虽然 UNCOVER-EH 的重点是美国，它已经产生了重要的差异，可以为其他区域提供一个有用的模板以供考虑。UNCOVER-EH 的调查结果确定了扩大合作伙伴关系和研究活动的关键机会。加强非传统伙伴关系是必要的，因为美国各地的公共卫生系统支离破碎，导致各州、部落和领地社区之间在提供卫生计划方面效率低下和不公平。一年多前，建议启动一项全国范围的研究计划，以解决环境公共卫生实践和相关研究需求的优先挑战（https://ehp.niehs.nih.gov/doi/10.1289/EHP5161）。这一及时而重要的努力有望改进基础科学发现对常规和新出现的健康威胁的转化。它将刺激创新，改善当地社区的健康状况，增加我们对公共卫生的投资回报，并且对于更好地重建至关重要。来自 UNCOVER-EH 的观察也对这一领域的专业招聘和培训发人深省。大多数环境公共卫生专业人员负责提供许多不同的项目，这些项目对社会运作至关重要。其中一些包括疫情控制、卫生、饮用水、食品安全、媒介控制、危险废物管理和群众集会支持。他们必须是问题解决者和通才，当他们出现在社区中时，经常会面临新的威胁。然而，这些专业人士中有 26% 预计将在 5 年内退休，而此时只有 6% 的公共卫生学生正在接受这种培训。公共卫生人力的这一重要部分似乎工作过度、人手不足和老龄化。事实上，作为 UNCOVER-EH 的一部分，保留和招聘合格员工被列为美国最重要的两个专业优先事项（表 1）。www.cdc.gov/nceh/ehs/uncover-eh/index.html。我们需要增加全球环境公共卫生专业本科生和研究生的数量。扩大培训并要求获得证书，例如美国注册环境健康专家 (www.neha.org/professional-development/credentials/rehsrs-credential) 或英国的 Charted Status (https://www.cieh.org) /membership/chartered-status/) 可以提高当前劳动力的准备程度。作为 UNCOVER-EH 的一部分，特别建议创建一个新的国家培训计划，以加强环境公共卫生人员的准备工作 (https://ehp.niehs.nih.gov/doi/10.1289/EHP5161)。然后发生了 COVID-19。我们在世界各地的同事响应大流行响应号召。他们在事件指挥中心服务，进行接触者追踪，并促进疫苗接种的推广，同时努力维持他们的日常工作，以确保我们的食物、空气、水和社区安全。环境公共卫生专业人员累了，已经筋疲力尽（https://www.neha.org/sites/default/files/flipping_book/neha-covid-19-eh-workforce-needs-assessment-ii-report/）。尽管一些国家目前正在经历 COVID-19 病例的下降，但在其他国家，大流行仍在继续，新的病毒株正在出现，它继续给医疗保健系统带来相当大的压力。公共卫生专业人员的压力是显而易见的。例如，在美国，员工因倦怠、政治压力甚至死亡威胁而辞职。过度工作、人手不足和老龄化的劳动力需要我们的帮助。我们需要振兴环境公共卫生人力。现在，环境公共卫生比以往任何时候都更重要。在美国，新政府带来了新的希望，并迎来了加倍努力抗击 COVID-19 的机会。我们还必须解决环境公共卫生差异和环境正义问题，同时加强努力应对气候变化的复杂、多方面威胁。拜登总统最近发布了一项行政命令，以建立一个 COVID-19 大流行病检测委员会，并确保为 COVID-19 和其他生物威胁提供可持续的公共卫生人力。该行政命令专门确定了美国公共卫生工作队的创建。除了加强对公共卫生工作者的培训以支持检测、疫苗接种和接触者追踪外，该命令还确定了“其他紧急的公共劳动力需求”。该命令进一步表明，美国公共卫生工作队将“为受 COVID-19 大流行影响的美国人提供其他必要的服务”。来自 UNCOVER-EH 的及时劳动力建议 (https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2019。305441) 与 2019 年的大流行和所有危害防范和推进创新法案相结合，为现在和将来支持这些基本活动提供了途径。加强和确保可持续的环境公共卫生人力是及时、紧迫和必要的。有证据、需要和千载难逢的机会来重建得更好。我们必须致力于更有效、更高效、更公平地向当地社区提供必要的环境公共卫生服务，以应对 COVID-19 及以后的情况。现在是振兴美国环境公共卫生的时候了；这样做可能会为世界上其他情况类似的地区提供一个有用的模板。我们的健康取决于它，因为我们加强了与当前流行病的斗争并为即将到来的威胁做好了准备。本社论中表达的观点是作者的观点，不一定代表 ACS 的观点。本社论中表达的观点是作者的观点，不一定代表 ACS 的观点。
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