CHARLOTTE, N.C. (AP) — A significant number of individuals and programs aimed at maintaining public health in the U.S. are disappearing. State and local health departments, which handle essential operations such as restaurant inspections, monitoring harmful germs in wastewater, and safeguarding community health, are increasingly under-resourced.
Experts indicate that the Trump administration is making unprecedented cuts to health spending. There has been a withdrawal of $11 billion in direct federal support, leading to the elimination of 20,000 jobs at the National Health Organization, which partially funds local public health initiatives. Further cuts are also proposed.
Leaders in public health argue that these reductions have diminished the entire system, threatening vital everyday functions at a time when the nation is vulnerable to diseases such as measles, whooping cough, and avian flu.
This shift signifies a move away from established public health principles, prioritizing individual responsibility over collective action for health protection.
Here are key insights from the Associated Press investigations on the impacts of federal public health cuts on communities across the U.S.
Invisible illness prevention is being overlooked
Preventive work is often subtle and unrecognized. It’s difficult to pinpoint those who have benefited, as successful efforts mean people are unaware they have avoided serious health threats thanks to preventative measures.
For instance, the Mecklenburg County, North Carolina Health Department operates a mobile clinic that visits high schools to ensure students receive necessary vaccinations for diseases like measles and polio. These vaccinations not only safeguard students but also bolster overall community health when enough individuals are immunized.
Various programs run by the U.S. health department aim to reduce suicide rates, prevent drug overdoses, enhance prenatal care, and assist individuals in quitting smoking. They also provide education, conduct testing, and offer treatment for diseases such as HIV and tuberculosis. Some health departments, like Mecklenburg, also operate medical and dental clinics.
Studies indicate that investments in public health yield significant economic returns. For every dollar spent on childhood vaccinations, it is estimated that the country saves $11. Additionally, for cigarette cessation, the return is $2-$3; and for asthma control, it is $70.
Washington’s turmoil threatens lives
State and local health departments rely heavily on federal funding. The U.S. Centers for Disease Control and Prevention allocates around 80% of its budget to states and localities, providing expertise and resources crucial for public health.
When the Trump administration unexpectedly cut $11 billion from state and local health services in March, followed by the dismissal of thousands at the CDC within a week, public health leaders warned that these cuts severely harmed communities nationwide.
All eight staff members dedicated to Mecklenburg’s mobile vaccination effort were terminated. In Columbus, Ohio, nine disease intervention specialists were let go just as the city prepared for potential measles outbreaks. Nashville had to shut down its free flu and COVID testing program.
Additionally, vital services such as the tobacco hotline, early intervention for children with hearing impairments, and drowning prevention programs have been adversely affected as CDC personnel were laid off.
A spokesperson for the U.S. Department of Health and Human Services stated that they are reorganizing what they termed a “broken system” and rejected claims that HHS has forsaken emergency health threats.
HHS defended the grant cancellations by stating that the funding was linked to the COVID pandemic, which they believe has ended. Nonetheless, many crucial areas—such as epidemiology, laboratory capacity, and vaccination—remain critically important given today’s health landscape.
Connecticut’s state health commissioner emphasized during a Democratic legislative hearing that the current uncertainty poses “a critical threat to our lives.”
Public health funding is deteriorating—and the situation is worsening
These recent cuts are especially damaging as the health sector is funded differently compared to other government entities aimed at safeguarding public welfare. Public health officials often contrast this with fire departments, which are always prepared and do not scramble to assemble resources when a fire is already ablaze.
A temporary influx of funds during the pandemic allowed many health departments to expand and enhance their programs. However, by early this year, most of that funding had dissipated, alongside other COVID-related grants nationwide—as those programs came to an end. Consequently, these departments find themselves fragile and vulnerable once more.
In Chicago, one-time COVID grants constituted 51% of the health department’s budget, and their expiration will lead to staff reductions that fall below pre-pandemic levels.
In Mecklenburg, the department has lost 180 employees due to the depletion of COVID funds. They also lost a partnership for wastewater monitoring with the University of North Carolina at Charlotte, which could have facilitated rapid responses to emerging threats like avian flu.
And these cuts aren’t over.
The Trump administration has proposed further significant reductions to the CDC budget, potentially halving agency funding. Since CDC sends approximately 80% of its budget to state and local entities, these cuts threaten the very foundation of public health.
Public health leaders warn that relentless reductions within the system will cripple the sector’s ability to address both new pandemics and the resurgence of old diseases across the United States.
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Unger reported from Charlotte and Louisville, Kentucky, while Smith contributed from Providence, Rhode Island. Associated Press reporter Mary Conlon also contributed to this report, along with Kenya Hunter from Atlanta.
Source: apnews.com