Report: States and Localities Face Reduced Support for Health Emergencies

Are local and state health agencies prepared for epidemics, natural disasters and acts of bioterrorism?

A study by Trust for America's Health (TFAH), a non-profit, nonpartisan think tank focused on disease prevention, revealed that many agencies have been targeted for budget cuts in recent years, potentially putting the public at a greater risk if a major health crisis occurs.

Their annual report, Ready or Not? 2011, was funded by the Robert Wood Johnson Foundation. Budget data was collected from the Centers for Disease Control and Prevention (CDC) and state and local public health departments.

The report concluded that preparedness programs could be dramatically reduced or completely eliminated if trends in federal budget cuts continue. Specifically, funding from Public Health Emergency Preparedness (PHEP) grants will have been reduced by $72 million from fiscal year 2010 to 2012, based on proposed cuts for 2012.  TFAH's key findings state that:

• 51 of the 72 cities that participate in the Cities Readiness Initiative, sponsored and funded by the CDC, could be eliminated from that program in 2012 because of the reduction in PHEP grants. The initiative ensures municipalities have the ability to quickly provide vaccines and other medications during an emergency.
• 10 state laboratories with Level I chemical testing capabilities, which receive PHEP grants, are at risk of losing that capacity. That would leave only the CDC in Atlanta with the ability to conduct full tests during chemical accidents or acts of terrorism.
• 24 states could lose the support of CDC experts, known as Career Epidemiology Field Officers, who aid state and local officials in preventing and responding to outbreaks and disasters, such as the H1N1 flu pandemic in 2009 and the oil spill in the Gulf of Mexico in 2010. Those positions are funded through PHEP grants.
• The country could have limited support from the National Center for Environmental Health, which is funded as part of the CDC's operational budget and could soon face cuts. The center is tasked with coordinating a comprehensive response to nuclear, radiological and chemical threats as well as natural disasters.

In fiscal year 2011, 40 states and D.C. cut their public health funding, according to TFAH -- 29 (plus D.C.) for the second consecutive year and 15 for the third consecutive year. Federal support for state and local preparedness efforts has decreased by 38 percent from fiscal year 2005 to 2012, adjusted for inflation.

The study anticipates further reductions as part of the sequestration cuts following the congressional joint deficit reduction committee's failure to reach a deal to reduce the federal budget deficit. The Congressional Budget Office has estimated that discretionary domestic spending will be cut by 7.8 percent under sequestration.

"If we have further reductions, I think it will have serious consequences for our ability to detect and respond to future public health events," Mel Kohn, state health officer for the Oregon Health Authority, said in a conference call with reporters.

TFAH offered a series of recommendations to federal, state and local policymakers at the conclusion of the report:

• Assure dedicated funding for strengthening public health agencies' core preparedness capabilities
• Improve biosurveillance to quickly detect and track outbreaks or attacks
• Improve the research and development of vaccines and medications
• Enhance public health agencies' ability to treat a large increase in patients during an emergency
• Provide increased support for communities to recover from outbreaks and disasters

For more information about how specific states and localities are being affected, visit the TFAH website.

The map below marks the 51 cities that could be cut from the Cities Readiness Initiative in 2012.



View Cities Readiness Initiative Cuts in a full screen map