Governmental Public Health Must Strengthen Its Strategic Communications Infrastructure - Not Just Training.

Scientific expertise, policy change, and community engagement are commonly understood as the primary tools of governmental public health. The COVID-19 pandemic made it clear that communications is also a core function. It also exposed the severe constraints of governmental public health's current communications capacity: inconsistent funding, understaffed teams, narrow authority within agencies, and an overreliance on dissemination-focused roles. Together, these constraints leave public health communications poorly equipped for today's environment. Public health agencies and funders typically address gaps in communications capacity by emphasizing training programs to build individual skills. While necessary, this emphasis is insufficient. We review evidence to suggest that the most persistent challenges facing governmental public health communications result not from individual skill gaps, but from underinvestment in communications infrastructure. Without sustained investment in leadership roles, workforce pathways, and narrative capacity, training alone cannot enable communications to best serve the needs of our communities' health. We deliberately use the plural "communications" to signal organizational function, distinguishing it from the singular communication infrastructure of communities described in the broader literature. Together with other communications leaders in Big Cities Health Coalition member health departments, we have begun to outline a strategic vision for local government public health communications. In this perspective piece, we outline our initial thinking about how to move our field forward strategically.