Resilience or Ruin? The Future of U.S. Public Health

America’s Public Health System Is at a Crossroads

Leadership upheavals, funding cuts, and political interference are reshaping the CDC, FDA, and NIH.
This exclusive report from This Week in Public Health examines how these changes are fragmenting America’s ability to prevent disease, respond to outbreaks, and protect equity nationwide — and what can still be done to rebuild.

Drawing on months of analysis and scenario modeling, Resilience or Ruin? is a data-rich, plain-language briefing for policymakers, practitioners, and health advocates who need to understand where the U.S. public health system is heading between now and 2028.

Inside the Report

• The Crisis: Shrinking infrastructure, fractured authority, and delayed guidance inside federal agencies.
• The Stakes: What declining immunization rates and data modernization freezes mean for local health departments.
• The Futures: Three scenarios — Renewal, Retrenchment, and Stalemate Federalism — outlining America’s possible paths.
• Local Case Studies: Mississippi, Chicago, Navajo Nation, and Florida Panhandle — what system strain looks like on the ground.
• Rebuilding Pathways: Actionable strategies for federal, state, community, and practitioner levels.
• Trust & Narrative: How to rebuild legitimacy through transparency, communication, and community partnership.

Who It’s For

✔️ Public health professionals and agency leaders
✔️ Policy analysts and grantmakers
✔️ Health journalists and communicators
✔️ Educators and graduate programs in health policy or implementation science

What You’ll Gain

• A clear, evidence-based picture of what’s happening inside U.S. public health institutions.
• Practical frameworks for resilience and reform at every level — federal, state, local, and practitioner.
• A blueprint for rebuilding trust in science and government during an era of fragmentation.

Use This Report To

• Brief your leadership team or board.
• Frame funding proposals around systemic risk and resilience.
• Teach or present current policy dynamics in classrooms or workshops.
• Spark informed discussion among peers, partners, and coalitions.

Edition Details

• Released: October 2025
• Format: PDF (49 pages)
• Publisher: This Week in Public Health | Part of the PubTrawlr Network

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