New Report Highlights Tremendous Stress on Local Health Departments

On April 28th, the National Association of County and City Health Officials (NACCHO) released a report entitled, “2020 Forces of Change: The COVID-19 Edition,” detailing several major COVID-related hurdles for local health departments (LHDs).nurse with stethoscope

The report details survey results gathered by NACCHO between October 2020 and March 2021 measuring the impact of the COVID-19 pandemic on local public health capacity. Four major findings from the report confirm the many difficulties faced by our LHDs:

  • 51 percent of all LHDs experienced harassment as a result of COVID-19 protective measures enacted in 2020 and 65 percent reported that federal, state and local agencies did not provide any additional support or protections in response to the public backlash.
  • Decades of federal disinvestment in public health left LHDs without the appropriate resources and staff to adequately respond to the pandemic. As a result, 71 percent of all LHDs had to hire at least one additional staff member to assist with their COVID-19 response operations, with 24 percent adding an additional five to 25 staff members.
  • 80 percent of LHDs had to divert resources from core public health interventions, such as environmental health programs, in order to maintain sufficient staffing for the COVID-19 response.
  • Preventive health programs, including those supporting maternal and child health, obesity prevention and substance use disorder, decreased capacity by over 60 percent.

County health departments provide essential public health and prevention services to residents, such as screenings and immunizations, conducting surveillance to detect and monitor emerging infectious diseases, protecting the food and water supply, and preparing for and responding to natural disasters and other public health emergencies. In Maryland, LHDs are charged with providing certain core services including communicable disease control, environmental health, family planning, maternal and child health, wellness promotion, and adult and geriatric health.

Noting harassment faced by LHD officials in Maryland, MACo provided support for two pieces of legislation, HB 267/SB 298 and HB 1409/SB 956, seeking additional state protections for said officials. In 2021, MACo successfully advocated for HB 1123/SB 563, which will increase state funding for the above mentioned LHD core services beginning in fiscal year 2025. The funding may also be used toward updating data management systems and providing any needed technology and personal protective equipment to respond to an acute communicable disease outbreak. Despite Maryland’s investment, the NACCHO report makes clear additional federal investment is needed to boost workforce and operational capacity for local health departments.

Read the full NACCHO report.