Public health departments and programs are often the first and last line of defense against chronic disease and acute health problems. Unfortunately, their funding, and with it their ability to help protect and provide for health and safety, is being eroded.
The facts are grim: Public health budgets have been cut drastically in recent years. According to the Trust for America’s Health, only 17 states did not cut funding for public health from 2008/09 to 2009/10. In 2010, more than half of local health departments reported reductions in their core funding. This trend continued in July 2011 when 45 percent of LHDs reported reduced operating budgets compared to the previous fiscal year, and more than half (52%) expect cuts in the next fiscal year as well. In 2010/11, states have cut funding for tobacco prevention and cessation programs by 12 percent.
These cuts have a real impact. Local health departments (LHDs) have lost about 33,000 employees since 2008, with more than four in ten LHDs losing at least one employee. With fewer employees and resources, services suffer. In 2010 and 2011, 55 percent of all LHDs made cuts in at least one program, and 27 percent made cuts in three or more programs. Because some programs such as restaurant inspections are mandatory, these cuts often fall hardest on programs that are extremely important but not required by law, such as maternal and child health wellness initiatives.
As we reported earlier, the Affordable Care Act (ACA) creates a new Prevention and Public Health Fund to assist state and community efforts to prevent illness and promote health. Under the ACA, the Fund was to receive amounts increasing from $500 million in FY2010 to $2 billion in FY2015 and thereafter. Amounts distributed under the Fund so far have been used both to support promising new programs as well as to offset some of the losses being suffered by cutbacks in other funding.
But President Obama’s proposed fiscal year 2013 budget includes massive cuts to prevention and public health programs, including an 11% cut to the Centers for Disease Control and Prevention’s budget and reducing the Prevention and Public Health Fund by $4.5 billion over the next ten years. The reality turned out to be even worse for the Fund: In February 2012, the Middle Class Tax Relief and Job Creation Act was passed by Congress and signed by the President. It contains cuts to the Fund of $6.25 billion over ten years.
Almost a year ago, when similar budget cuts were proposed, the Network published a blog post about the value of long-term investment in public health and the need for public health practitioners to speak-up about the impact of funding investments in the health of Americans. With the 2013 budget still to be debated and enacted, that advice is as important now as ever.
This information was developed by Corey Davis, staff attorney, for the Network for Public Health Law – Southeastern Region at National Health Law Program.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state