Open letter to Iowa’s State Legislators

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An open letter of appreciation from the voice for public health in Iowa.

On behalf of the more than 400 members of the Iowa Public Health Association (IPHA), thank you for your leadership and continued service to Iowans as we all face the biggest public health crisis in our lifetime.

The COVID-19 pandemic has shown the essential role of public health, highlighting the link between prevention, preparedness, and the prosperity of Iowa’s economy and the resiliency of our communities.

The legislature now has an opportunity to reimagine and maximize our investment in Iowa’s public health infrastructure and to prioritize equity in our policy decisions. Each vote you take, has the potential to protect and improve the health of Iowans, our families, workforce and communities.

IPHA is non-partisan nonprofit organization committed to a healthy and thriving Iowa. We are here as your partner for evidence-based information. We welcome your questions and requests for information.

We ask you to consider the following as you discuss policy proposals and Iowa’s FY 2021 budget:


The legal authority of the State of Iowa, including the Iowa Department of Public Health (IDPH) and the Office of the Governor, is critical in preparing for, preventing, detecting, managing and containing a public health disaster.

There are efforts to restrict this authority under the false pretense that the IDPH or the Governor has the authority to 1) mandate coronavirus vaccination when available and 2) remove the current medical and religious exemptions for immunizations to attend school. Neither of these assertions are correct.

To the contrary, when it comes to vaccination, the government’s authority lies in management of the distribution of vaccines during a shortage, and prioritizing who is able to receive vaccines. The full scope of the legal authority of the State of Iowa during a public health disaster is available here.


A stable state funding model that provides flexible funding to local public health is necessary to modernize and support Iowa’s public health infrastructure.

State funding supports the critical work of local public health agencies, IDPH, and the State Hygienic Lab (SHL). These pillars of public health serve to minimize the number of vulnerable Iowans through effective public health principles and practice, and by working with local community providers and organizations. Together, they are Iowans’ front line of prevention not just during a pandemic but every single day!

The state’s current investment in IDPH ($54,390,157 FY 2019) represents only 23% of the department’s total budget. The majority of Iowa’s public health funding comes from federal sources, which have been on the decline in recent years. As COVID-19 has shown us, the need for stable and flexible public health funding at the state and local level is higher than ever, and your support is critical at this time.

Iowa’s local public health agencies know their communities’ strengths and needs. They, in partnership with IDPH and the SHL, are best equipped to assess and manage local health risks. Yet, only a small portion of our public health dollars supports local public health directly (see chart).

Investment in local infrastructure delivers a return measured by improved access to care, control of diseases, reduced health disparities, and improved workforce productivity. Improving and protecting the health of all Iowans is the pathway to prosperity.


Finally, the SHL’s appropriation is tethered to the Board of Regents budget in the annual education appropriations bill. It should be moved to the Health and Human Services budget to understand the full picture of public health infrastructure in Iowa.


All sectors should be involved in planning for the health of our communities and workforce (e.g. housing, nutrition, transportation, education, water and air quality, criminal justice, and employment).

Health is more than your doctor’s office and hospital. The social, physical, and economic environments in which Iowans live, work, learn, and play significantly impact our health. For example, residents in Keokuk (Lee County) live an average of 10 years less than residents in Spirit Lake (Dickinson County). The same disparate range occurs within the counties. Residents in parts of Des Moines will live 10 years less than residents in Ankeny (Polk County).

These difference link back to the investments we make that support people’s ability to make healthy choices. The healthy choice should be the easy choice. Investing in cross-sector partnerships, including state-level agreements, will create the environments in which Iowans can thrive economically and as healthy and productive members of our communities.

Our current environment has strongly demonstrated that Iowa’s public health infrastructure is the first and last line of defense for public health crises and promoting health and wellness. In partnership with policymakers, we can make a stronger public health infrastructure a priority by providing supportive policies and adequate, sustainable funding. Thank you for your consideration.



The leadership of Iowa Public Health Association

Sherri Marine, President

Jeremy Whitaker, President-elect

Angela Doyle Scar, Treasurer

Jacob Riley, Secretary

Virginia Barrette, Board Member

Chris Espersen, Board Member

Shelley Horak, Board Member

Mary Mincer Hansen, Board Member


Pamela Mollenhauer, Board Member

Danielle Pettit-Majewski, Board Member

Kady Reese, Board Member

Rachel Schramm, Board Member

Brandon Rohrig, Advocacy Committee Co-chair

Deborah Thompson, Advocacy Committee Co-chair

Lina Tucker Reinders, Executive Director