A survey conducted by the National Association of County and City Health Officials has found that local public health departments in this country have lost almost 40,000 employees to budget constraints since the recession began in 2008. In 2011, 57% of all health departments reduced or eliminated services in at least one program area. These funding cuts hurt local public health departments.
According to the survey, emergency preparedness services were cut by 23 to 24%, environmental health services were cut by 17 to 20%, food safety programs were cut by 10 to 12%, and epidemiology and surveillance services were cut by 9 to 10%.
Almost two-thirds of the United States population lives in an area that reported reductions to at least one program area. Thirty-nine percent of the U.S. population lives in an area that cut funds to three or more program areas.
Some local health department leaders told NACCHO that “so far, we are holding our own, [but] if the financial cuts continue, it will have a huge impact on the services that we can offer.” One health official said, “My staff has not had a raise in three years. The moral is low.” That official could not recruit for a half time position because “my professional nursing staff are now paid approximately $10 less an hour than if they were employed in the hospital, clinic, or long-term care in my community.”
Local and state health departments are often the first to discover a foodborne illness outbreak. In fact, the Salmonella Paratyphi B outbreak started in Buncombe County, North Carolina and was investigated and managed by that county’s health department until the outbreak broke state lines. The FDA then took over the investigation.
One source of public health department funding is The Prevention and Public Health Fund, part of the Patient Protection and Affordable Care Act of 2010. In February 2012, the Fund was cut by $6.25 billion. The U.S. House of Representatives passed bills in 2011 and in May 2012 to completely eliminate this funding source, although the U.S. Senate has not followed suit and President Obama has vowed to veto such efforts.
These political moves could cost this country billions of dollars. The NACCHO report states that “an investment of $10 per person per year in proven community-based programs … could save the country more than $16 billion annually within five years. This is a return of $5.60 for every $1.”
The report concluded that “a bad situation that began in 2008 continues to deteriorate. Although a similar percentage of local health departments report losses from study to study, cuts in one period often compound cuts in prior periods. For example, if an LHD cuts its food safety program each year and never expands it, restaurant inspections conducted in the community may occur less frequently.”
NACCHO surveyed 957 local health departments in a random sampling to accurately portray national and state estimates.
