Pandemic highlights cracks in public health funding, infrastructure

Pandemic highlights insufficiencies in public health funding

MONTGOMERY, Ala. (WSFA) - The pandemic is prompting a national outcry to bolster public health funding, both on the state and federal level.

The once-in-a-lifetime pandemic continues to reveal funding, or the lack thereof, has played a central role in the strength of the government’s response.

Alabama Public Health Officer Scott Harris admits the agency’s resources 10 years ago would have been better equipped to respond to COVID-19.

“We frankly weren’t prepared for it like we wish we could have been,” Harris acknowledged.

As for a boots-on-the-ground assessment of Alabama’s public health infrastructure, “I’d say it’s a little rickety, we currently don’t have things in place we wish we had.”

There have been no sharp cuts in funding. For the Alabama Department of Public Health, it’s been death by 1,000 cuts over the last decade leading up to the COVID-19 crisis.

“Unfortunately, we’ve had some difficult years,” Harris acknowledged. “We have a county without a public health department, for example, we don’t have the same number of staff working on the county level that we have had in the past.”

State records indicate the loss of key programs, the subsequent revenue and unfilled positions through attrition or retirement have contributed to a 65% staff reduction on the county level over the last 12 years.

“It’s not any one person’s fault,” he said. “It’s just that there’s a lot of competing needs out there and there’s never enough resources to go around. But it’s become really difficult to try to keep up with all the things that we’re statutorily required to do. Things like inspecting restaurants, taking care of septic tanks and following up on animal bites.”

Some states have abandoned the county health department model due to dismal funding, but Harris believes it’s important for Alabama. Not only do the county health departments offer direct medical services, most are now a mainstay in the vaccination rollout.

Despite the elevated need, the combination of local funds to help run those departments are drying up as well.

“Public health is really a fundamental thing that protects every single Alabamian and we prioritize the health and safety of everybody in our state,” Harris added. “We are helping to provide medical care and medical guidance for a lot of people that have no other way to access it, they don’t have any other way to get it if we’re not here to do it.”

New pandemic-related needs are demanding more from the state’s coffers and those who work for ADPH. During a typical year the state’s epidemiology team investigates a couple thousand infectious disease cases. That number’s skyrocketed to nearly half a million in 11 months.

Harris says there’s also a growing need for data analysis.

“We need a dedicated group that can take these big, different piles of disparate data from all these different locations and all these systems that don’t talk to each other, and try to put them together in a usable way that gives us really time sensitive information that we can act on when we need to.”

One-time federal dollars have helped fill in the gap in some instances, the solution for long-term resources is still to be determined.

“I think that we’ve certainly identified what a lot of our challenges are and now it’s up to us to try to figure out a path forward.”

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