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Report: Cuts In Federal Funding Put Public Health Preparedness At Risk

Oregon health authorities quickly traced an August outbreak of foodborne illness to a strawberry field in the state. But will they be so swift next time?
Oregon health authorities quickly traced an August outbreak of foodborne illness to a strawberry field in the state. But will they be so swift next time?

Do you remember the E. coli outbreak that started in an Oregon strawberry patch this August?

Probably not, because public health officials there pinpointed the farm responsible for the affected fruit with the first (and only reported) death, and confirmed the source of the bacteria less than two weeks later.

Oregon's State Public Health Officer Mel Kohn, says federal funds made the quick response possible. The money supported both the epidemiologists who studied the case and the state lab that confirmed the source of the outbreak.

And while Kohn is proud of how Oregon handled the strawberry incident, the findings of the ninth annual Ready or Not report worry him, he told reporters in a media briefing. The public health system's readiness for emergencies is at risk, he said.

The sobering report was released earlier this week by the nonprofits Trust for America's Health and the Robert Wood Johnson Foundation, which also provides funding to NPR.

Their verdict? We're far better prepared for public health emergencies since the Sept. 11 attacks and anthrax mailings in 2001, but budget cuts are chipping away at those gains.

The report looks at a range of scenarios, including some pretty bleak ones based on drastic federal cuts. There are a few areas of particular concern.

One initiative at risk is the Center for Disease Control and Prevention's Cities Readiness Initiative, which helps with distribution of vaccines and antibiotics in a crisis. Ready or Not found that 51 of the 72 cities involved could be cut from the program based on current budget scenarios.

Additionally, budget cuts could hobble labs in 10 states that are able to test for for threatening chemicals. That would leave the U.S. Center for Disease Control as the only public health lab able to test a full range of toxic chemicals and nerve agents.

Loss of funding has already started to weaken the public health system. Ready or Not reports that nationwide, 49,310 state and local public health jobs have disappeared since 2008.

"Our health security is dependent on this funding from the federal government," Oregon's Kohn says, adding that his state isn't unique. Public health funding is discretionary spending in most state budgets, meaning it's at high risk of getting cut in bad economic times.

In the past year, 40 states and the District of Columbia have cut their public health budgets. In 15 states, it's the third straight year of budget reductions.

"The Great Recession is taking its toll on emergency health preparedness," says Jeffrey Levi, head of the Trust for America's Health. "We're seeing a decade's worth of progress eroding before our eyes."

Kohn credits federal funding for Oregon's success in managing H1N1 influenza during the 2009 outbreak. Without federally funded labs within the state, the samples would have had to travel all the way to Atlanta in order to find out whether or not people were infected with bird flu, significantly slowing response time.

Given the budget and staff cuts, Kohn is worried Oregon will no longer be able to coordinate statewide emergency efforts the way it did in 2009. Whether the threat is an earthquake, the flu, or a bioterrorist attack. "Some of our local jurisdictions simply won't have the ability to prepare for and respond to an event," Kohn says.

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Jordan Calmes