By Ankit Sanghavi, MPH, BDS
Executive Director, Texas Health Institute
The recent rise in whooping cough cases in Texas is more than an infectious disease trend; it is a stress test of the systems many families quietly rely on when a child is sick. Surges like this one reveal not only the clinical demands of a specific condition, but the deeper question of how well our health care and public health systems work together to protect communities.
Imagine a parent of a newborn hearing a cough that feels “unusual.” Their first call might be to a pediatrician, a primary care clinic, or a local health department. Regardless of which door they enter first, families want the same thing: clear guidance, timely support, and the assurance that the systems around them are steady and coordinated. This is where primary care and public health function as complementary pillars, two entry points into one ecosystem of protection.
Across the country, both sectors are navigating workforce challenges, rising expectations, and fluctuating authority. The recent whooping cough outbreak reinforces a national reality: system resilience depends on strong clinical care, strong public health, and the connective tissue between them. States vary in how these systems are organized, but the underlying lessons are widely shared.
Primary care provides continuity, early diagnosis, and family-centered guidance. Accessible same-day care, care coordination, school-based clinics, and community health centers all help prevent small problems from escalating into crises. When primary care is strained, through chronic underinvestment, clinician shortages or fragmented pathways, the entire system feels the effects.
Public health provides population-level protection, surveillance, and prevention. Local health departments track clusters, support schools, facilitate vaccination, and help ensure consistent communication across hospitals, urgent care centers, EMS, and dental and primary care practices. Investments in community surveillance, modern immunization systems, and data connectivity strengthen every part of the health system, not only during outbreaks, but every day.
Public health capability is essential, but trust determines whether capability translates into action.
As John Hellerstedt, MD, Texas Health Institute board member and former Texas Department of State Health Services Commissioner often reminds us, “institutions cannot simply request trust, they must demonstrate value, clarity, and integrity in ways that resonate emotionally.” Families connect most with stories: infants protected by timely vaccination, schools able to stay open because outbreaks were managed early, or a clinician who recognized pertussis quickly and helped a worried parent navigate the next steps. These moments build credibility.
In an era of information overload, gratitude is one of our strongest tools. Most parents continue to vaccinate. They deserve to hear that their decisions protect their communities, especially the youngest infants who are most vulnerable. Reinforcing this majority strengthens the social norms that keep communities safe.
Preparedness requires sustained infrastructure, not episodic attention.
The systems that matter most, immunization registries, school health protocols, local health departments, contact tracing teams, and primary care clinicians, cannot be built during a crisis. They must be funded and supported consistently. The public health workforce challenge is, at its core, a funding challenge. Communities are more willing to support that investment when they clearly see how it protects the people they care about.
Whooping cough, like other infectious disease, exposes where systems are strong and where alignment still needs investment. For states and municipalities aiming to build more resilient systems, several priorities stand out:
- Invest in the public health and primary care workforce as a sustained commitment, not a surge response.
- Build durable, bi-directional data pathways between public health and health care to support shared situational awareness.
- Support school and community health infrastructure as essential, not peripheral, components of system readiness.
- Promote prevention through clear, accessible, trust-centered communication that acknowledges and reinforces the majority who already take protective actions.
Disease outbreaks will rise and fall over time, but families will continue to expect systems that feel competent, compassionate, and coordinated. Meeting that expectation, across public health, primary care, and community settings is how we strengthen our nation’s resilience and the trust that sustains it.
