ANALYSIS IN DEPTH The nation’s public health agencies are ailing when they’re needed most

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Tue, 2020-09-01 09:49 — mike kraft

The nation’s public health agencies are ailing when they’re needed most It is one of many weaknesses that left the United States ill-prepared for a pandemic. Chelsea Janes, William Wan Washington Post

At the very moment the United States needed its public health infrastructure the most, many local health departments had all but crumbled, proving ill-equipped to carry out basic functions let alone serve as the last line of defense against the most acute threat to the nation’s health in generations.

Epidemiologists, academics and local health officials across the country say the nation’s public health system is one of many weaknesses that continue to leave the United States poorly prepared to handle the coronavirus pandemic, which has claimed more than 180,000 lives in the country.

That system lacks financial resources. It is losing staff by the day. And its shortcomings are especially evident in the context of the Trump administration, which has taken a largely hands-off approach to virus response and left local leaders to steer their neighbors through the crisis.

Even before the pandemic struck, local public health agencies had lost almost a quarter of their overall workforce since 2008 — a reduction of almost 60,000 workers, according to national associations of health officials. The agencies’ main source of federal funding — the Centers for Disease Control and Prevention’s emergency preparedness budget — had been cut 30 percent since 2003. The Trump administration had proposed slicing even deeper.

While the country spends roughly $3.6 trillion every year on health, less than 3 percent of that spending goes to public health and prevention, according to an April analysis by the nonprofit Trust for America’s Health.

The dilapidated state of the nation’s public health infrastructure has never been a secret, exposed time and again by problems such as the opioid crisis and persistent racial disparities in health-care access and treatment. But the problems have been left to fester. ...

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