We Shouldn’t Wait for a Crisis like Coronavirus to Fund Public Health

Dr. Sharon Balter, at the podium with Los Angeles County Department of Public Health officials, talks about a patient taken to a hospital with coronavirus symptoms at a news conference in Los Angeles on Jan. 26, 2020.

Dr. Sharon Balter, at the podium with Los Angeles County Department of Public Health officials, talks about a patient taken to a hospital with coronavirus symptoms at a news conference in Los Angeles on Jan. 26, 2020. AP Photo

 

Connecting state and local government leaders

COMMENTARY | During emergencies, state and local agencies will be lauded for their efforts and suddenly flush with funding. But then the money disappears. It’s time to break that cycle.

The World Health Organization has declared coronavirus a “global health emergency”. For weeks, the potentially disastrous consequences of this deadly virus have dominated news headlines throughout the U.S. and around the world. For those in the field of public health, while the coronavirus itself may be new and is certainly an emergency, in some ways it is also quite familiar.

Talk to any longtime veteran of a government health agency, and they can tell you all about the incredible amount of work and coordination needed to address diseases like SARS, H1N1, Ebola, and Zika. They can tell you about the urgency placed on them to find a cure and prevent the spread of these illnesses, as well as the sudden influx of long-needed resources finally at their disposal. They can tell you about the human-interest stories written lauding their efforts to protect the health of the nation. They can also tell you that once the spotlight on a given disease starts to fade, the accolades—and, more importantly, the funding—quickly disappear.

The government public health workforce plays a critical role in protecting and promoting the health of the people they serve. With expertise in issues ranging from infectious and chronic diseases to disaster preparedness to environmental health and maternal and child health, the approximately 290,000 individuals who work at the federal, state, and local levels dedicate their lives to improving people’s health. Despite the key roles that they play, from food inspection to responding to natural disasters and the opioid epidemic, public health agencies lack the resources needed to effectively provide critical services and programs.

Since the Great Recession that began in 2008, local public health departments have eliminated more than 56,000 jobs, and state and local governmental public health has dealt with insufficient funding levels. At the same time,  nearly half of the workforce is considering leaving their operations in the next five years, whether to retire or for other reasons. At the same time, positions like nursing continue to be difficult to fill at the state and local level, especially with high levels of stress and burnout .

Health departments have come up with innovative approaches to address these funding and workforce shortages, such as staff-sharing arrangements. These efforts are creative and forward-thinking, but more is needed.

To successfully tackle today’s greatest public health challenges, a workforce of sufficient size and with the appropriate skill sets is needed. This requires allocating adequate funding—not just to react to today’s emergency, but to help prevent and address the emergencies of tomorrow.

On his show “Mister Rogers’ Neighborhood,” Fred Rogers is remembered for his thoughtful response on dealing with tragedy and disaster: “When I was a boy and would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’” The importance of state and local government workers, such as public health professionals, is too often only recognized during times of disaster. Diseases like coronavirus should not be needed to fully appreciate the tireless work of these dedicated individuals. Instead, always ‘look for the helpers’—and provide them with the resources they need to do their jobs.        

Rivka Liss-Levinson, PhD, is the research director at the Center for State and Local Government Excellence.

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