As I reflected while writing this, I thought back to my early days working with state health departments. Back then, no formal training programs or strategic public health goals guided new workers. Annual reports rarely included measurable objectives or cohesive plans. That was many years ago, and while each state now has its own unique orientation process for public health staff, I have serious doubts that 50 state health departments are actively considering a comprehensive Five Essentials Platform to present to their governors as a way to prevent and treat the costliest public health challenges.
The Five Essentials—affordable housing, healthcare, healthy food, transportation, and childcare—may seem obvious, yet they are not always recognized as the fundamental pillars for advancing public health or addressing the nation’s five most costly health challenges. Critical discussions about these essentials are often absent from public health strategy meetings. More strikingly, conversations around the outsized influence billionaire philanthropy and corporate interests exert over these vital services—and over entire public health departments—are largely missing. However, confronting this influence and advocating system‑wide reforms is exactly what public health professionals must prioritize today if the United States hopes to build equitable and sustainable frameworks for health and well‑being.
The 5 Essentials Platform book collection is designed to change that conversation—and to make sure public health isn’t carrying this fight alone. Across seven books, the series invites a whole ecosystem of change agents to the same table: public health advocates, university researchers, public school leaders, city reformers and mayors, candidates for governor and current state leaders, AI innovators, and everyday altruists who refuse to look away. Each audience brings a different kind of power—data, narrative, policy, organizing, technology, and lived experience—but the goal is shared: make the essentials truly affordable for all.
In each city, the “secret sauce” of the affordability movement is not a single hero or sector, but the alignment of these seven arenas around a common platform and a common language. When researchers back community demands with evidence, when school leaders turn campuses into hubs for services, when mayors and governors run and govern on pro‑affordability agendas, when technologists build tools that serve people instead of oligarchs, and when everyday altruists keep the pressure on, billionaire influence stops feeling untouchable. The fight against that influence—including elected officials captured by it—is not easy and not quick. But city by city, state by state, coalition by coalition, we can move from scattered efforts to a coordinated movement that fights to win—and expects to.
Disclaimer: This blog post, the Affordable Cities for All website, and the 5 Essentials Platform book collection reflect the personal views and independent work of Dr. Dominic Cappello and are not affiliated with or endorsed by any institution of higher education. The vision, mission, and random typos are all mine—Dr. Dom.
