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NACCHO Releases Comprehensive Survey of U.S. Local Health Department Funding, Programs, and Partnerships

Aug 06, 2020 | Andrea Grenadier

— New data shines spotlight on public health department activities prior to pandemic; points to need for enhanced investment through pandemic and beyond —

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NACCHO Releases Comprehensive Survey of U.S. Local Health Department Funding, Programs, and Partnerships

Washington, DC, August 7, 2020 – Today, the National Association of County and City Health Officials (NACCHO), representing the country’s nearly 3,000 local health departments, released its 2019 National Profile of Local Health Departments (Profile) report. The Profile is a comprehensive survey of local health department infrastructure and practice that NACCHO administers every three years, to present a complete and accurate overview of the state of local health department funding, workforce programs, and partnerships, as well as how these factors have changed over time.

The Profile is a critical resource health departments, policymakers, and researchers to better understand funding, workforce, capacity, and other aspects that affect the way services are resourced and delivered by local health departments in their communities and how they compare to health departments of other sizes or in other states.

The COVID-19 pandemic response has placed the work of local health departments into the spotlight, and the Profile is especially relevant as a primary data source to a variety of stakeholders interested in the work of governmental public health. Now more than ever, data is a critical commodity as the country navigates through the demands and exigencies of the pandemic. Armed with sound and useful data, health departments can make actionable decisions based on evidence collected by the Profile study. This evidence can serve as a pre-COVID baseline to benchmark responses to the pandemic.

Key Findings

  • Workforce capacity is down. Local health departments experienced a loss of 21% of their workforce capacity over the past decade, an additional challenge to a timely and robust local public health response to COVID-19. In 2008, LHDs had 5.2 full-time staff per 10,000 people; in 2019, they had 4.1.
  • Resources are limited. In 2019, 15% of local health departments reported decreased budgets relative to the previous fiscal year, and 52% experienced flat funding, despite inflation, population growth, and the increasing complexity of public health challenges. Budget shortages profoundly affect health department emergency preparedness and response programs. In 2019, more than 80% experienced either a decreased or stagnant preparedness budget, compared to the previous fiscal year. The economic impact of the COVID-19 pandemic on local and state tax revenue is expected to exacerbate these challenges.
  • Services have been impacted. New Profile data also show that, as a result of budget and staffing changes, health departments reduced their level of service provision for several services critical to COVID-19 response. For example, 84% either reduced or had no changes in their provision of emergency preparedness services. In 2016, it appeared emergency preparedness was a growing service, but its provision has been stagnant in recent years. The prolonged lack of financial and human resources allocated to bolstering health departments’ emergency preparedness work has posed a challenge during this uncertain time.

Additional information can be found in the full report or the 2019 Profile research briefs on workforce and finance capacity or emergency preparedness and response capacity.


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