Since 2008, local public health departments in the United States have lost nearly 40,000 employees, and the situation continues to deteriorate, according to the most recent survey, conducted in January and February, by the National Association of County and City Health Officials (NACCHO).


One health official told NACCHO that “fiscal year 2013 is shaping up to be the worst fiscal year for us … We may have to reduce or eliminate certain programs, should the financial situation worsen.”

Another official was even gloomier: “Next year will present a large challenge and even threatens our continuance. In 25 years I’ve not confronted this level of threat to our existence as a going entity. Our situation is dire.”

Hardest hit areas have been clinical health services, emergency preparedness and maternal and child health programs. Food safety efforts have also suffered. 

The most recent study brief notes that annual cuts in food safety programs may mean an area’s restaurant inspections may occur less frequently. Previous reports have said nearly half the states are at risk of losing career epidemiology field officers and that the nation may be ill-prepared to handle a major food safety emergency.

The research brief released this week also highlighted these findings:

– Fifty-seven percent of all local health departments reduced or eliminated services in at least one program area in 2011, a larger percentage than in any 12-month period since the recession began.

– Nearly two-thirds of the U.S. population lives in an area experiencing at least one program area cut, while 39 percent reside in areas reporting three or more program area decreases.

– Curtailed funding pushed health departments to eliminate more than 5,000 staff positions during the second half of 2011, more than triple the number they gained.

For this latest report, the seventh in a series, NACCHO surveyed 957 local health departments selected as part of a statistically random sample designed to provide national and state-level estimates. A total of 663 local health departments across 47 states participated, a response rate of 69 percent.