By Chrissie Juliano, MPP, Director of the Big Cities Health Coalition
This year’s American Public Health Association’s (APHA) National Public Health Week (NPHW) challenges us to think about what the “Healthiest Nation 2030” means. As we focus on this charge, we find ourselves again working to defend huge cuts in public health funding at the Centers for Disease Control and Prevention (CDC) and elsewhere.
A leaked version of the President’s budget suggests cuts of more than $300 million from CDC’s already austere budget in this fiscal year (through September 30) alone. This agency is the center of public health in America and sends millions of these dollars to local communities across the country. Our Big Cities Health Coalition members, leaders of America’s largest metropolitan health departments, count on this funding - that generally flows from CDC, to states and then to communities - to prevent disease and help people live healthier lives in communities across the nation. Such deep cuts to the CDC means less support for important local public health programs, such as protection from infectious disease outbreaks and foodborne illnesses, and work to address the opioid and chronic disease epidemics we continue to face.
In seeking to create the healthiest nation in one generation, APHA asked members and partners to take 1 billion steps before the week began. As they, and so many of us know, becoming more active is a first “step” in reversing a stark reality: chronic disease, such as cancer, heart disease, and diabetes, are responsible for 7 of every 10 deaths among Americans each year and account for 75% of the nation’s health spending. These diseases are largely preventable, and if we get Americans moving, we could see real health gains in a relatively short period of time.
These are the conversations our nation must keep having about its health. These are the goals we must continue to strive to reach, rather than turn back the clock in a nation where, too often, America’s health care debate focuses too narrowly on insurance coverage and prescription drugs. Access to primary medical care is important, but just doesn’t tell the whole story. More importantly, it alone doesn’t keep us healthy. All too often we focus on the CARE, but forget the HEALTH, missing important opportunities to prevent disease in the first place. Not to mention, the enormous role that prevention plays in avoiding unnecessary personal and economic hardship.
The good news is that cities are at the center of evidence-based policy innovations to address urgent public health issues, like the lack of physical activity or explosion of sugar in our kids’ diets.
- Philadelphia recently passed a sugar-sweetened beverage tax to combat the wave of obesity and chronic disease that is creating a drag on the city’s health and economy. The new revenue will focus on a host of things that can make communities healthier – universal pre-k, libraries, recreation centers, and upgrades to physical activity options, all targeted at kids most at risk.
- Clark County (Las Vegas) recently developed mobile apps to help residents not only take advantage of the numerous walking, biking, and hiking trails in their area, but also to help calculate the amount of sugar is soda, juicers, and energy drinks.
- Fulton County (Atlanta) is using a collective action approach, convening multiple sectors to work to address the problem of diabetes in their community, developing hands-on tools and a curriculum, among other things, to use in the county’s schools.
Other stakeholders are working with city health departments to make a difference. In 224 communities across the nation, YMCAs are working in collaboration with other community leaders on an effort to ensure that healthy living is within reach. To date, communities participating in the Y programs have influenced more than 35,900 community-level changes that have impacted up to 65 million people across the nation.
Local and state health departments are strong, but the draconian cuts coming from the White House, likely paired with Congressional imposed cuts to the Prevention and Public Health Fund would be catastrophic to our nation’s health. The Fund supports core public health programs that work to keep Americans healthy and safe every day. The Trust for America’s Health projects that the state of California, home to seven BCHC member cities, would lose more than $300 million in grants from CDC over the next five years if the Fund were eliminated. More than $7 million in vaccine funding and approximately $13 million in chronic disease funding would be jeopardized. The state of Texas, home to four BCHC member cities, would lose more than $147 million in grants from the CDC over the next five years. Budget reductions this severe mean that important state and local public health programs that support lead prevention, immunizations, and first responders for disease outbreaks would be decimated.
Preventing disease in our communities and meeting APHA’s goal to become the “healthiest nation in one generation” requires funding for local public health departments and community assets across the nation. Promoting prevention not only improves the health of Americans, but can also help to keep rising health costs under control. When we invest in local public health, the benefits are broadly shared, and the results mean healthier communities for all.