Restoring gold standard science. Implementing radical transparency. Making America healthy again. While these are all worthy goals for science and health care, they will likely be undermined by deep staff and resource cuts and structural changes imposed on our nation’s public health institutions.
Unless the public health infrastructure is strengthened, continued cuts may lead to worse health outcomes and the erosion of trust in the government. To improve Americans’ quality of life, increase life expectancy and prevent costlier healthcare spending in the future, the federal government must recognize the serious need to invest in — not weaken — the nation’s public health infrastructure. Failing that, states will need to shoulder some of the burden, strengthen public-private partnerships, and invest in the tools and resources to bridge the gaps.
What might this look like?
To help minimize workforce cuts caused by a reduction of federal funding, some state and local public health departments are shifting staff to roles supported by different funding streams. Others are partnering with local Community Emergency Response Teams to cross-train volunteers to support vaccine clinics and disaster-preparedness programs to protect public health during emergencies.
Meanwhile, public health departments are increasingly seeking nongovernmental funding sources to help expand their capacity and invest in much-needed surveillance and data collection technologies. For example, the Wichita Falls-Wichita County Public Health District in Texas was able to enhance its mosquito surveillance and mitigation program this year with support from a grant from the National Association of County and City Health Officials.
Universities and nonprofits are stepping up as well. For instance, the Bentson Foundation recently provided a generous donation to the Center for Infectious Disease Research and Policy at the University of Minnesota to establish the CIDRAP Information Hub, which will serve as a public clearinghouse for trusted information about infectious diseases and vaccines. Similarly, Brown University’s Pandemic Tracker, Fordham University’s Tick Index and the Cornell College of Veterinary Medicine’s bird flu dashboard are all invaluable resources that provide the public and policymakers with reliable details about emerging threats.
In the wake of the federal government’s regressive policies, states are being forced to find creative ways to maintain their public health programs. This includes funding systems to strengthen disease monitoring, expand syndromic surveillance, and manage immunization information systems — all at the state level.
By investing in tools that can increase the efficiency of the monitoring of public health data from multiple sources in real-time, state public health departments should still be able to identify worrisome trends and craft strategic interventions that save lives and protect communities, and save taxpayer dollars.
Promising solutions include California Syndromic Surveillance and Johns Hopkins University’s innovative Electronic Surveillance System for the Early Notification of Community-based Epidemics. These powerful technological tools can help states to analyze, visualize and track developing public health threats, enabling rapid responses to emerging threats.
While these are all significant efforts, the effects of the devastating cuts to federal funding — and consequent job losses and program reductions — will be felt for years. Although underinvestment in public health is not new, the United States has achieved impressive public health victories nevertheless. The key to these successes has always been a commitment to evidence-based policy and investment in technology and tools that empower local leaders and public health officials to identify and respond to emerging threats.
Until the federal government expands funding for public health measures, state and local governments will be forced to find funding where they can. Only by investing in and exploiting a spectrum of partnerships and technologies can state and local health departments respond to emerging public health threats even in the absence of federal support. Although not an ideal solution, it is the only option we have until the federal government renews its commitment to public health at the local, state and national levels.
Henry I. Miller, a physician and molecular biologist, is the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. He wrote this for InsideSources.com.
