The CDC Reorganization and its Impact on NIOSH

May 28, 2004
The Centers for Disease Control and Prevention (CDC) has new goals and with those goals comes a reorganization that place the National Institute for Occupational Safety and Health into a new Coordinating Center for Health Promotion.

The reorganization evolved from an ongoing strategic development process called the Futures Initiative, which began 1 year ago at CDC and has included hundreds of employees, other agencies, organizations and the public.

CDC Director Julie Gerberding said CDC will align its priorities and investments under two health protection goals:

  • Preparedness: People in all communities will be protected from infectious, environmental and terrorists threats.
  • Health Promotion and Prevention of Disease, Injury and Disability: All people will achieve their optimal lifespan with the best possible quality of health in every stage of life.

In addition, the agency is developing more targeted goals to assure an improved impact on health at every stage of life including infants and toddlers, children, adolescents, adults, and older adults.

The integrated organization coordinates the agency's existing operational units into four coordinating centers to help the agency leverage its resources to be more nimble in responding to public health threats and emerging issues as well as chronic health conditions.

"For more than half a century, this extraordinary agency with the greatest workforce in the world has accomplished so much for the health of people here and around the world," said Gerberding. "However, today's world, characterized by tremendous globalization, connectivity and speed, poses entirely new challenges. The steps we are taking through this initiative will better position us to meet these challenges head on. Our aim is to help ensure that all people are protected in safe and healthy communities so they can achieve their full life expectancy."

The new coordinating centers and their directors are:

  • Coordinating Center for Infectious Diseases &endash; Includes the National Center for Infectious Diseases, the National Immunization Program, and the National Center for STD, TB, and HIV Prevention. Dr. Mitchell Cohen will lead the center.
  • Coordinating Center for Health Promotion &endash; Includes the National Center for Chronic Disease Prevention and Health Promotion and the National Center for Birth Defects and Developmental Disabilities. Dr. Donna Stroup will lead the center.
  • Coordinating Center for Environmental Health, Injury Prevention and Occupational Health &endash; Includes the National Center for Environmental Health, the Agency for Toxic Substances and Disease Registry, the National Center for Injury Prevention and Control, and NIOSH. Dr. Henry Falk will lead the center.
  • Coordinating Center for Health Information and Services &endash; Includes the National Center for Health Statistics, a new National Center for Health Marketing, and a new National Center for Public Health Informatics. Dr. James Marks will lead the center.

While Gerberding seems optimistic about the future of CDC and its operating units, others aren't so certain the move is a good one.

Franklin E. Mirer, Ph.D., director of the Health and Safety Department, of the United Auto Workers International Union (UAW), wrote Gerberding to express the concerns of the UAW with the impact of the reorganization on NIOSH. "The announced plan appears to downgrade NIOSH from a center directly reporting to the director of CDC, to a unit reporting to you through a new layer of management," he wrote.

He noted NIOSH plays a critical role in the health of the nation, pointing out, "working Americans spend upwards of 40 percent of their waking hours at work. The working environment is a locus of many unique exposures to health and safety hazards, as well as a potential arena for many prevention programs. The working environment is not the primary mission of the traditional stakeholders in CDC, such as state and local health departments or health care institutions."

Mirer said the UAW is concerned that NIOSH is placed under group/cluster with an environmental focus. He added that historically, "this combination has lead to neglect of the occupational environment." The union also is concerned that "reduced status will lead to reduced importance of the occupational environment, and possibly reduced funding."

Mirer urged Gerberding to rescind NIOSH's placement in the Coordinating Center for Health Promotion.

Gerberding plans to implement the changes by Oct. 1, the start of the next fiscal year.

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