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Reduced Federal Funding for Emergency Preparedness Puts the Nation’s Communities at Risk


Contact Becky Wexler
(301) 652-1558

Reduced Federal Funding for Emergency Preparedness Puts the Nation’s Communities at Risk

Trust for America''s Health''s "Ready or Not" report reveals preparedness gaps after a decade of progress

Washington, D.C. (December 20, 2011) – The National Association of County and City Health Officials (NACCHO) commends Trust for America’s Health and the Robert Wood Johnson Foundation for drawing attention to strained resources by releasing the ninth annual Ready or Not? report. This year’s edition underscores the negative impact that ongoing cuts to federal public health emergency preparedness have had on vital state and local programs that detect and respond to disease outbreaks, emergencies, and acts of terrorism.

“The last few years have strained our already fragile public health system,” said Robert M. Pestronk, NACCHO''s executive director. “We’ve had an outbreak of a new flu strain, several unpredictable natural disasters, and a global economic crisis that continues to affect all sectors of American society. Local health departments are part of a safety net for all people in their communities, but with a workforce already stretched thin, it’s only a matter of time before the net lets the unsuspecting through.”

TFAH’s Ready or Not? cites the most up-to-date economic impact data from membership surveys conducted by both NACCHO and the Association of State and Territorial Health Officials. Since 2008, 49,310 state and local public health department jobs have been lost to layoff and attrition – 14,910 in state health agency central offices and 34,400 in local health departments. NACCHO’s July 2011 job loss and program cuts survey data also showed that between July 2010 and June 2011, more than half (55 percent) of all local health departments reduced or eliminated at least one program. Emergency preparedness ranked second on the list of programs experiencing significant reductions.

Among other findings, Ready or Not? warns that declines in federal funding have put 51 of the 72 cities including Baltimore, MD, Kansas City, MO, and Portland, OR at risk for program elimination in 2012. These cities are part of the Centers for Disease Control and Prevention (CDC)-funded City Readiness Initiative which helps large metropolitan areas, with greater population density prepare to dispense medicine quickly and on a large scale.

“Local health departments work hard to plan, train, and prepare for emergencies,” said Pestronk. “But at this critical juncture of dwindling funding and difficult choices, health departments are now doing less with less. Budget cuts and a declining public health workforce challenge their ability to protect the health and well-being of all people in their communities.”

NACCHO’s members are frank about the bind they are in. For example, leaders of the strapped Bay County Health Department, in Bay City, Michigan, worry that if a new strain of the flu were to break out, the department might have to turn away some community members seeking vaccinations. Bay County’s workforce is now 20 percent smaller than it was when the H1N1 crisis occurred and 40 percent smaller than it was just six years ago. The health department has seen its budget shrink by 10 percent since 2010, and it expects more cuts in the next fiscal year.

Bay County Health Director Barbara MacGregor’s biggest fear is that the county won’t be prepared in the event of a large scale disaster or emergency. “We’re prepared as best we can be, but you have to have human beings,” she said. “You can have all the equipment you want in the world, but if you don’t have the people on the ground doing the work, you’re not going to be successful. With continued federal cuts to emergency preparedness and local health department funding in general, we are being set up to fail.”

For more stories from the field and the latest NACCHO job loss and program cuts report, visit

About the National Association of County and City Health Officials
The National Association of County and City Health Officials (NACCHO) represents the nation''s 2,800 local governmental health departments. 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.