Federal and state budget cuts are taking a measurable toll on the food safety system, according to a new analysis by the Trust for America’s Health and Robert Wood Johnson Foundation.
Economic slowdown and widening deficits have led to scaling back programs that respond to foodborne illness outbreaks, bioterrorism, and other incidents, and, unfortunately, disasters tend to not discriminate between good times and bad. The authors of the ninth annual report, Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism, are concerned the trend towards fiscal austerity is having a negative impact on public health.
“We’re seeing a decade’s worth of progress eroding in front of our eyes,” said Jeff Levi, PhD, executive director of Trust for America’s Health (TFAH). “Preparedness had been on an upward trajectory, but now some of the most elementary capabilities – including the ability to identify and contain outbreaks, provide vaccines and medications during emergencies, and treat people during mass traumas – are experiencing cuts in every state across the country.”
Since 2008, just under 50,000 state and local public health department jobs have been lost to layoff and attrition, according to the most recent data released by the National Association of County and City Health Officials (NACCHO) and the Association of State and Territorial Health Officials (ASTHO). NACCHO’s July 2011 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.
According to NACCHO, the Bay County Health Department in Bay City, Michigan illustrates the tough position many health departments are in. The Bay County HD workforce is 20 percent smaller than it was when H1N1 broke out and 40 percent smaller than it was six years ago. Between 2010 and 2011 the HD’s budget shrank 10 percent, and there are more cuts on the horizon.
Bay County Health Director Barbara MacGregor worries the county won’t be prepared if a disaster or emergency situation strikes.
“We’re prepared as best we can be, but you have to have human beings,” said MacGregor. “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.”
When it comes to food safety, the report warns that 24 states are at risk of losing Career Epidemiology Field Officers — from Arizona to Maine to Florida. The report also lists weaknesses in biosurveillance as an ongoing gap in preparedness, an issue that has been raised by food safety experts for many years.
“There is no standardized, interoperable system using up-to-date technology,” notes the report. “Currently, there are major differences in states’ ability to collect and report data, which hampers bioterrorism and disease outbreak identification and control efforts.”
The Food Safety Modernization Act was a positive step towards greater coordination and oversight, according to the report, but some state and local public health officials will be forced to balance fewer resources with the new responsibilities required under the law. Rebuilding a system based on prevention and better detection will take investments, and the report expresses concerns about properly funding the U.S. Food and Drug Administration to implement the measure.
Though the agency received a boost in the final appropriations bill for the next fiscal year –when most other agencies faced caps or cuts — the report notes that future funding is uncertain and suggests creating a more stable source of funding for food safety, such as a registration fee for food facilities.
The report is meant to be a wakeup call to policymakers.
“During the anthrax attacks and Hurricane Katrina, we witnessed what happens when public health doesn’t have the technology, resources, workforce or training needed to respond to emergencies,” said James S. Marks, senior vice president and director of the Health Group of the Robert Wood Johnson Foundation. “The old adage is that it’s better to be safe than sorry. Unfortunately if we ignore preparedness now, we’ll be sorry later when the next emergency strikes.”
The full report can be found here.