For decades, public health churned quietly in the background, an invisible shield that kept populations safe and minimized disease spread.

Before the recent pandemic, most Americans knew little about the national, state or local public health structure. During the recent 100-year COVID-19 pandemic, public health became front and center in America and caught the eyes of elected officials. Finding fault with public health actions during the pandemic, several states enacted new laws and measures to govern its operations and scope.

Thus, like other campaign issues, public health is now part of modern-day politics.

Although public health and healthcare are different — public health focuses on keeping the community healthy, whereas healthcare focuses on individual health — they are intertwined.

Considering the broad and important role of public health, and that changes in public health policy will affect community and individual health, we, the voters, need to know how our elected officials approach the related issues.

Below are a few — not all — of the positions we must consider from those entrusted to represent us. First, there are community threats. What do your candidates believe are the biggest public health threats your community faces? What measures will they put in place to provide eyes and ears for what is happening in public health?

When faced with new infectious disease threats, like the last pandemic, what is the strategy for containment or mitigation?

Who will lead this response, and what will be your candidates’ role? Next is food safety. Federal lawmakers are increasingly focusing on nutrition and Americans increasingly value the importance of nutrition.

At the same time, we recently went through a national outbreak of cyclosporiasis that came from the food supply and sickened tens of thousands of people.

What would your candidates do locally and nationally to help ensure food safety? If there is a food-related outbreak, how would they respond, and what type of resources would be needed?

Candidates should also address children’s mental health. Youth behavioral health was already in a difficult state when the pandemic hit and has worsened since. Some states have pulled back on collecting information about the mental and behavioral health of children. What would your candidates do to assess children in our communities?

What services are currently available in your community, and are they adequate? What types of programs would your candidates consider to address mental health needs in your community? Discussion of vaccination requirements is essential. Our country is seeing declines in vaccination rates of children entering school.

Some say it is their right to determine whether their child is vaccinated, citing personal choice, whereas others are supportive of vaccination requirements for school attendance. Where do your candidates come down on this issue? Ask candidates if your region is experiencing outbreaks of serious, vaccine-preventable illnesses.

What would be their response to an outbreak of measles or pertussis in the community where you live? What would be the role of the local Department of Health in managing this outbreak? There’s also the impact of climate change.

Climate change-related events are resulting in more wildfires, excessive heat exposure and increases in insect-borne illnesses.

This impacts recreation in and outside of schools and affects overall individual health. What do your candidates perceive of the local and regional impact of climate change?

What measures would they put in place to deal with this issue? On healthcare, an individual’s ability to obtain medical care is often dependent upon their ability to obtain health insurance.

Last year’s One Big Beautiful Bill Act will result in some losing health insurance coverage. The recent elimination of 750,000 enrollees covered under the Affordable Care Act means that thousands will no longer have health insurance coverage.

It is also well recognized that individuals without regular healthcare will have increased emergency room utilization at a time when such facilities are overburdened. What do your candidates propose to address this situation? The delivery of healthcare and hospital sustainability in rural settings is another increasing challenge.

Thanks to the One Big Beautiful Bill Act, rural hospitals will be under increasing financial pressure, and it is projected that many will close. The Rural Health Transformation Program has the potential to have an impact but will not compensate for related loss of hospital funding.

It is also projected that up to 33 percent of rural hospitals will close in the near future. What state-level initiatives will your candidates champion to support struggling rural hospitals? Finally, candidates should address policy development. Developing public health policies can be complex both in terms of scope and the information needed for their development. How will your candidates collect information related to public health policies?

Which organizations will they work with? How will they balance information from leading medical organizations versus that from non-traditional medical organizations? Now that public health is a visible part of American politics and of great importance to our individual and community well-being, we hope that those already elected and those running for office give public health the attention needed. Scott A. Rivkees, MD, is a pediatrician.

He is the former state surgeon general and secretary of Health of Florida.