CONTEXT: In response to the COVID-19 pandemic, Congress passed the American Rescue Plan Act of 2021 (ARPA) that included a historic investment in the public health workforce. PROGRAM: Charged with implementing this investment, the U.S. Centers for Disease Control and Prevention (CDC) launched the Public Health Infrastructure Grant (PHIG). PHIG builds on CDC's experience working with state, local, and territorial public health departments and represents a new approach to strengthening the public health workforce. IMPLEMENTATION: Specifically, PHIG incorporates features that allow these public health departments to prioritize and tailor the funding to meet their communities' needs: 1) focus on workforce as core infrastructure, 2) streamlined programmatic and administrative requirements, 3) more equitable funding approach, and 4) enhanced support from national partners and CDC. DISCUSSION: The goal is to optimize the unprecedented opportunity afforded by ARPA and lead to a stronger public health workforce and infrastructure across the United States.

Firearm-related violence is a significant public health problem that requires a comprehensive approach to prevention that includes engagement and action by clinicians and health care systems. The effects of firearm-related violence on health care include immediate treatment for injuries, long-term care (eg, for spinal cord injuries and trauma), and a substantial toll on clinicians related to secondary traumatic stress. Firearms are the method of injury for most homicides and suicides (79% and 53%, respectively, in 2020).1 The circumstances of 2020, including the COVID-19 pandemic and community–law enforcement tensions related to law enforcement use of force, have potentially contributed to increased risks for homicide and suicide, including exacerbating the social and structural factors that drive racial and ethnic inequities.1

Adverse childhood experiences, commonly referred to as ACEs, are potentially traumatic events that occur in childhood and adolescence, such as experiencing physical, emotional, or sexual abuse; witnessing violence in the home; having a family member attempt or die by suicide; and growing up in a household with substance use, mental health problems, or instability due to parental separation, divorce, or incarceration.1 Since the publication of the ACES Study by the Centers for Disease Control and Prevention and Kaiser Permanente in 1998,2 more than 2 decades of research have documented the association of ACEs with health and well-being across the life span.1-3

Consider “Jane,” a 30-year-old female patient brought in by emergency medical services (EMS) to the emergency department (ED), reflecting just one of more than 100,000 opioid overdose patients treated in EDs each year. Naloxone, an opioid antagonist and overdose reversal drug, was administered in the field by EMS; however, additional rounds of naloxone were required in the ED because of high opioid potency. Once she was stabilized, a quick review of her chart revealed several recent visits for opioid-related overdoses. A review of her history revealed that she was prescribed opioids initially in the ED 5 years earlier after sustaining minor injuries in a motor vehicle crash. She began misusing prescription opioids during the following year, receiving prescriptions from multiple providers in primary care clinics and EDs. Yet, because a check of the state’s prescription drug monitoring program was not completed before any prescription, her use of multiple providers and high dosages was not identified, and opioids continued to be prescribed in different clinical settings for pain management. Soon thereafter, Jane initiated heroin use and presented to the ED several times with cellulitis from injection drug use, as well as after an overdose of prescription and illicit opioids. Each time, she was discharged without a referral to substance use treatment or without a naloxone kit.