As we wrap up National Public Health Week (April 3-9, 2023), I want to take a moment to say thank you and reflect on the important work done by the thousands of individuals who serve in local health departments. Thank you for all you do for your communities, but also for the nation as a whole. In my remarks below, I explain the importance of local public health.
Each year, National Public Health Week recognizes the contributions of the public health field to improve the country’s health. As the voice of the nation’s nearly 3,000 local health departments, NACCHO is proud to honor the work of its members in unprecedented times. Public health has been in the spotlight for the past several years as we’ve led the country through the COVID-19 crisis, but we do so much more to protect the health and safety of our communities, including, but not limited to, immunizations, food safety programs, screening and treatment for both chronic and communicable diseases, maternal and child health services, epidemiology and surveillance, and environmental health services. When public health is doing its job well, we don’t make headlines. But that doesn’t mean we don’t need the support of our community members and policy makers to continue to address these more “everyday” challenges.
A few weeks ago, we held our first-ever virtual/in-person hybrid “Local Public Health on the Hill Day.” During the March event, more than 100 public health leaders met with 120 members of Congress spanning 30 states to speak with a collective voice for local public health. I’d like to share some of the key messages that came up time and time again in these important meetings.
First, we must break the boom-and-bust cycle of funding for public health and instead invest in public health workforce and infrastructure, at all levels including the local health department level. Much of the funding received by local health departments is tied to specific diseases (e.g., COVID-19, diabetes) or programs (e.g., breastfeeding support, opioid overdose prevention). While departments have delt with these silos for many years, it is clear that they do not provide the flexibility needed to truly support the many needs of a community. Local public health departments need sustainable, disease-agnostic funding that can be used to support core public health infrastructure activities such as communication, outreach, data analysis, and digitalization. Investing in these core public health capabilities will strengthen and support all the important work done by local health departments and ensure more efficient use of other resources. The CDC’s Public Health Infrastructure and Capacity Program is an important first step, but we need Congress to bolster funding to that program and to make sure that a meaningful amount of that funding reaches local health departments quickly.
Second, we need a strong focus on health department workforce needs. The public health workforce is the backbone of our nation’s governmental public health system; we cannot do our work without our people. But the workforce is facing a crisis that predates COVID-19 and worsened during the pandemic response. Local health departments lost 21% of their workforce capacity in the decade before the pandemic and need at least 54,000 more full-time equivalent positions — an increase of 70% — to provide a minimum set of public health services. We are grateful that Congress recognized the challenges facing the public health workforce and passed bipartisan legislation at the end of 2022 to establish a Public Health Workforce Loan Repayment Program for public health professionals who agree to a three-year service commitment at a local, state, or Tribal health department. This was a big victory for NACCHO and its members who have been advocating for this program since well before the pandemic began; however, the program cannot get off the ground without sufficient funding. NACCHO is asking Congress to fully fund the Public Health Workforce Loan Repayment Program in Fiscal Year 2024.
Third, we must support local health departments as they do the hard work of public health. The Public Health Workforce Loan Repayment Program is an important tool, but it’s just one piece. During the COVID-19 response, local health department staff worked long hours, they faced increased politicization of public health measures, and some were even the target of harassment or threats. This all took its toll: many public health workers are experiencing burnout and more than half report symptoms of post-traumatic stress disorder. Our lawmakers can help support the current public health workforce through mental health resources and through refocusing on science and evidence-based public health policymaking.
In serving their communities, local health departments follow the science as they work tirelessly on today’s most compelling and intractable challenges. We also need to be ready for the next national health crisis. Our members lead the way, expanding their resourcefulness, creativity, and deep reserves of expertise that grow every year to protect our communities and advance our nation’s health.
During this National Public Health Week, we are proud of the dedication and sacrifice of our members and are deeply committed to supporting you as you strive to improve the health of all communities.
