The U.S. public health system has, for good reason, been preoccupied with COVID-19 since March 2020. However, COVID-19 is not the only concern–and coping with it has meant shortfalls in addressing other diseases. For example, since 2019, there has been less screening for syphilis and gonorrhea, and infection rates have increased sharply for both. With the worst of the pandemic apparently behind us, it is time to address other risks, such as maternal health and chronic diseases, that have been sidelined for the last three years.
With substantial federal funding available, state governments have an opportunity to reset their approach. Public health is not a matter of chasing the latest disease, but patient, long-term thinking, based on each state’s circumstances. Different states have different challenges, risk profiles, demographics–and often sharply different outcomes.
That is one of the conclusions of McKinsey’s United States of Public Health dashboard, which collected data for all 50 states on a wide range of health conditions and factors. Consider maternal mortality: The worst-performing state has a rate of maternal death that is more than 14 times that of the best-performing state; for Chronic Obstructive Pulmonary Disease (COPD) and syphilis, it’s more than three times.
We cannot expect every state to catch up quickly in every area–but they can all improve. A mere 1% reduction in disease burden–1% less time lived with disease or injury–could translate into 5 million additional healthy life years in the U.S. each decade.
There would also be economic benefits. With fewer early deaths, more people would be employed. With less chronic disease, fewer would be unpaid, informal caregivers. And little of this requires doing anything new. Previous McKinsey research estimated that the United States could reduce its disease burden by as much as 30% by applying known practices and interventions.
The first step is for public health authorities in each state to define which disease areas hurt their people the most, and which interventions could be the most helpful. In a country as diverse in geography and demographics as the United States, the answers will vary: it may be environmental health in one state or preventing overdoses in another. What matters is to determine priorities.
Once this has been done, the next step is to scale up solutions. Here, a few principles apply widely.
Scale what works
Too often, states have deployed effective interventions for public-health challenges, but not widely enough. Pilots are not scaled up, or they are only applied to some regions. Now is the time to go big on proven interventions. For example, New Jersey has established universal home visitation for birth and adoptive families within the first two weeks. This has been shown to improve maternal and infant health, as well as longer-term child development.
Tailor interventions based on population needs
COVID-19 underscored deep inequities in the U.S. healthcare system, and this holds true in other disease areas, too. That's why it is important to find ways to understand the experience of your state’s residents and build partnerships with trusted institutions and leaders to ensure broad reach.
Reimagine how public health interacts with society
During the pandemic, state health departments worked intensively with a wide range of players, including employers, academia, faith-based institutions, and even sports teams to ensure access and treatment. Strengthening these partnerships to address the social determinants of disease could prevent disease and promote better health.
Digital innovation and analytics
Information is the lifeblood of public health: it’s essential for monitoring diseases and improving access. Now is the time to modernize public health data systems and to figure out how to use digital technology and analytics to better reach residents and meet their needs.
The public health challenge is daunting but not impossible. We have done it before. In the 1960s, 42% of adult Americans smoked cigarettes. Thanks to a mix of interventions, including information, taxation, restrictions on advertising, and social changes, that percentage had declined to 12.5% in 2020. Among high-school students, it's less than 2%. However, the United States has not been able to replicate that success in other areas, such as diabetes and mental health. Compared to people in many other developed countries, Americans are sicker.
We can do better. By identifying priorities and scaling up solutions, each state can build a healthier future for its residents–resulting in a stronger country.
Pooja Kumar is a senior partner in McKinsey & Company’s Philadelphia office. Ramya Parthasarathy is an associate partner in Silicon Valley.
The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.
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