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NACCHO Statement on RAND Study of State and Local Health Department Response to H1N1 Outbreak

Contact: Becky Wexler, Burness Communications
(301) 653-1558

Statement of the National Association of County and City Health Officials (NACCHO) on RAND Corporation Study of State and Local Health Department Response to H1N1 Outbreak
Washington, DC (July 8, 2009)
An article published this week in Health Affairs heightens the need to address workforce and funding constraints that are jeopardizing local health departments (LHDs) across the country. The RAND Corporation concluded that there was significant variation among local health departments’ provision of immediate, on-line information on H1N1 influenza. We disagree with the authors’ sole measure of performance, the speed with which state and local health departments posted information to their Web sites during the 24 hours after a public health emergency was declared by federal officials, because it overlooks extensive local use of radio, TV, and other print media for the emergency public communication that took place.  However, the study does underscore the resource challenges faced by health departments.

The report of the study notes correctly that local health departments are chronically underfunded and have experienced job losses and sharp declines in funding during the past year. In 2008, 7,000 local health department jobs were lost and that number is increasing in 2009. The combined impact of multiple state, federal,and local budget cuts threaten even existing LHD capabilities to respond to a future outbreak that has more severe consequences than the H1N1 event. 

NACCHO is grateful for the around-the-clock work done by every LHD to keep people safe and protected from disease—regularly and in times of crisis. Local health departments guard multiple fronts to defend people from any health threat, regardless of the source, and work tirelessly to prevent disease outbreaks. But as the RAND study authors assert in their article, without a sustained funding source and enough staff, it is not surprising to see some performance gaps.

NACCHO is the national organization representing the nation's nearly 3,000 local health departments. These agencies work every day on the front lines to protect and promote the health of their communities. NACCHO develops resources and programs and promotes national policies that support effective local public health practice.