NACCHO SURVEY: Local Health Departments Still Struggling to Recover from Recession

Sep 11, 2013, 1:40 PM

A review of a recent economic surveillance survey by the National Association of County and City Health Officials (NACCHO) finds that despite modest improvement, local health departments in the United States are still struggling to recover from the recent recession. NACCHO administered the survey as part of the National Profile of Local Health Departments in 2012, prior to the 2013 sequester cuts.

Just under 80 percent of the 2,700 local health departments in the country responded to the survey, which included questions about budgets, staffing and program cuts. Close to half of the health departments responding to the survey reported reductions in, or elimination of, services in at least one health department program area for last year, and 27 percent reported budget cuts. Analysis of the survey results also found that local health departments lost 43,900 jobs through layoffs or attrition since 2008. While positions remained stable last year, many local health departments have been unable to fill positions that were cut in previous years.

The survey also found that certain program areas have been especially hard hit by budget cuts, including immunization (22 percent of local health departments faced cuts ); emergency preparedness (15 percent); and maternal and child health (15 percent).

“While workforce reductions and program cuts may have slowed in some areas of the country in 2012, on the whole, the budgets of our nation’s local health departments are not keeping pace with the general recovery,” said NACCHO Executive Director Robert M. Pestronk. “In fact,” added Pestronk, who previously served as the director of Genesee County health department in Michigan, “continuing annual draconian cuts associated with sequestration will further erode local health departments’ capacity to serve and respond. If keeping people healthy and safe is a priority, then we should rebuild local response capacity and health security, not keep cutting it.”

Examples of the impact budget cuts have had on health departments include:

  • The Boston Public Health Commission (BPHC) was forced to limit its support of prenatal care services due to a five percent cut in federal funds for the Healthy Start Initiative. Other cuts resulted in the Health Commission losing community health worker positions that provided home visits to young families; case management for children and teens at risk of truancy; and services at school-based health centers.
  • Because of statewide budget cuts to local health departments in Maryland in 2009, the state’s Frederick County Health Department eliminated a third of its nursing positions. Before those cuts that health department held three flu clinics simultaneously, but now supports one clinic at a time, which has reduced the number of residents getting vaccines and keeps the department from achieving its public health emergency preparedness goals.

NACCHO’s economic survey and analyses is supported by the Centers for Disease Control and Prevention and by the Robert Wood Johnson Foundation.

>>Read NACCHO's release on the new survey.

This commentary originally appeared on the RWJF New Public Health blog.