Opinion - Whatcom View

POSTED: Saturday, Apr. 11, 2009

Leaders say public health system in jeopardy

You may not be aware of what public health does, but you certainly depend upon and benefit from its work every day. Currently, about 10,000 public health professionals in communities across Washington state do the work of public health that we all depend upon. They assure clean and safe water and food. They assure that children and adults receive vaccinations. They work to control infectious diseases, such as tuberculosis, E. coli, HIV and other sexually transmitted infections.

They work with schools and other organizations to prevent chronic diseases by preventing youth smoking and substance abuse and by promoting physical activity and healthy diets. Public health workers also visit at-risk families in their homes to help babies grow up to be healthy children. Healthy children do better in school and are less likely to become troubled youth.

The Whatcom County Health Department is part of a larger public health system in our community which includes schools, community health centers, medical care providers, businesses and community service organizations working together for a safe and healthy community. Local Health Departments pull this diverse system together and form the safety nets that keep our communities healthy. Just as building codes and fire prevention measures reduce the need and the expense of responding to preventable fires, public health must be able to both prevent problems and rapidly respond to emergencies as they arise. Public health work is cost-effective work that prevents disease and saves lives. For example, an intensive maternal support service for first-time, low-income mothers, saves society $3 for every $1 spent.

Last week was National Public Health Week. Across the country, communities are optimistic about the role public health can and will play in keeping our communities safe, especially as we focus on health care reform and face an economic recession. As former U.S. Surgeon General C. Everett Koop said "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time."

With the state budget introduced by the House of Representatives last week, we ask ourselves whether we will have similar cause for optimism about public health in Washington state. The House of Representatives' budget as introduced on April 1 will create a shocking $41 million loss for core local public health services, in addition to cutting millions more out of key programs. The public health system can not continue to function if these cuts continue.

These budget cuts are being proposed in spite of the fact that the Legislature's 2006 two-year bipartisan study found that the public health system in Washington state was underfunded by $300 million and recommended an immediate investment of $100 million. Since then, local public health has lost significant ground. This year alone, counties have been forced to cut $32 million and 250 workers from the local public health system due to local economic downturns.

What will happen if we allow our public health system to continue to erode? The short-term budget cuts we make now will lead to greatly increased health care, social and environmental costs in future years.

If the proposed House budget becomes our final budget important services in our community and across the state will be reduced or eliminated.

These include communicable disease programs, immunization programs, public health nurse home visits, help for children with special health care needs and WIC (Women, Infants, and Children) nutrition support.

In contrast to the House budget, the state Senate budget, while making some cuts to public health, preserves most of our basic funding.

Legislative leadership must recognize that the fissures in our public health system cannot be allowed to grow during this time of economic hardship. Now is the very time when public health programs that provide education, prevent disease, and plan for epidemics and other emergencies need to be funded as core functions of state government. We urge our elected officials to save public health by preserving the funding for the core services so vital to our community.

Greg Stern is Health Officer, and Regina Delahunt is director, of the Whatcom County Health Department.