Washington, DC, October 22, 2024 — Today, the National Association of County and City Health Officials (NACCHO), the voice of the over 3,300 local health departments across the country, released its recommendations for the incoming presidential administration and 119th Congress. Public Health is Local: NACCHO’s Recommendations for the Next President & 119th U.S. Congress highlights priorities to strengthen the overall public health sector by focusing on the needs and assets of local health departments.
NACCHO’s overarching recommendations for policymakers with respect to national public health policy are to:
- Strengthen and modernize the governmental public health system by improving the public health workforce, infrastructure, and data modernization
- Improve health for all Americans through investments in prevention and upstream interventions
- Maintain innovations and prepare for future public health emergencies
- Ensure local public health expertise informs federal priorities
Local health departments are on the frontlines of public health and play a unique role in the nation’s governmental public health system. The following recommendations provide federal policymakers with critical public health priorities and clear actions that, if taken, will improve the nation’s health and resiliency.
Strengthen and Modernize the Governmental Public Health System
Local health departments operate on limited and unpredictable budgets that do not allow for investments in necessary infrastructure or staffing. In the decade prior to the pandemic, local health departments lost over 20 percent of their workforce capacity, and it is estimated that 80,000 more full-time equivalents – an increase of nearly 80 percent – are needed to provide a minimum package of public health services. While emergency funding helped fill some staffing roles, those funds are expiring and the jobs they support are expected to disappear. Similarly, there is a need for more timely, accurate public health data during emergency responses, but also in non-emergency situations, to rapidly identify, track, and respond to daily public health challenges of all types.
To address these core issues:
- NACCHO urges prioritization of funding for the Public Health Workforce Loan Repayment Program to build a meaningful recruitment incentive to work in local, state, or Tribal health departments.
- NACCHO encourages federal agencies to include public health workers in available mental health support, in line with clinical health care providers.
- NACCHO recommends increased investments in the Public Health Infrastructure Grant (PHIG) program, and ensure these funds reach local health departments.
- NACCHO recommends increased investments in the Public Health Data Modernization Initiative and ensure that local health department needs are specifically incorporated into federal data modernization plans, federal data systems, and other investments.
Improve Health for All Americans Through Investments in Prevention and Upstream Interventions
Federal investments in local public health departments are increasingly critical as the nation’s life expectancy rates work to recover from recent declines and health care costs rise. Unfortunately, funding for public health initiatives has not kept track with the need. Moreover, cuts over time to the Prevention and Public Health Fund and through recent recissions put public health practice at risk.
To address these key funding challenges:
- NACCHO encourages the prioritization of public health funding, including its overall support of the Centers for Disease Control and Prevention (CDC), as well as to ensure these funds reach the local health departments so that all communities can benefit.
- NACCHO urges protection of, and restoration of previous cuts to, the Prevention and Public Health Public Fund.
- NACCHO strongly opposes future recissions of public health funds in budget negotiations and urges the Administration and Congress to work quickly and collaboratively on future emergency supplemental funding requests.
Maintain Innovations and Prepare for Future Public Health Emergencies
Recent emergencies, like the COVID-19 pandemic, natural disasters like Hurricanes Helene and Milton, or accidents like the East Palestine train derailment, have shown the important role local health departments play on the frontlines of protecting communities and coordinating with state and federal partners on emergency response. It also has highlighted important innovations and policies that should be supported to build our nation’s public health resilience.
To strengthen the system, NACCHO recommends the following:
- NACCHO urges the reauthorization of the Pandemic All Hazards Preparedness Act (PAHPA).
- NACCHO advocates for formal program authorization, adequate funding, and additional research to improve wastewater surveillance activities.
- NACCHO urges that public health is fully included in the nation’s cybersecurity preparedness framework.
- NACCHO urges the creation of a program that ensures access to vaccines for un- and under-insured adults; and to support immunization information data access across state and federal systems, while maintaining strong patient protections and data security.
Ensure Local Health Department Expertise Informs Federal Public Health Policy and Action
The role of local health departments is unique from that of state and federal levels. Their leaders and staff have unique insight into the many assets and challenges facing their community, relationships with key decision makers and trusted leaders, and can quickly mobilize local partners into action. This expertise is necessary to ensure that federal and state policies and programs are workable on the ground.
To ensure local expertise helps inform broader public health efforts:
- NACCHO urges that the next Administration and Congress work to ensure meaningful inclusion of local health department leaders and expertise in developing policy plans, actions, and guidance and implementation of federal programs and in state-level grantee policy and budget planning.
- In planning the future Administration leadership, local health department experience should be prioritized for key appointees, including for the incoming CDC Director.
NACCHO stands ready to be a partner to the next Administration and 119th Congress to improve public health so all Americans can thrive. View and download: Public Health is Local: NACCHO’s Recommendations for the Next President & 119th U.S. Congress.
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About NACCHO
The National Association of County and City Health Officials (NACCHO) represents the over 3,300 local governmental health departments across the country. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information, visit www.naccho.org.
