POLITICO article highlights crisis overlap pushing already strained public health resources to the brink, but it’s nothing new.

Local health departments across the country have faced challenges brought on by the omicron variant late in 2021 and the appearance of monkeypox in more recent months. In New York, the re-emergence of polio on the heels of the previous issues has appeared to compound an already crisis-level situation. This matrix of threats has shed even more light on public health preparedness, the effects of concurrent outbreaks, and the unprecedented rise in program demands, which has been felt here in Maryland even before the pandemic.

Erin Banco, a health correspondent at POLITICO, conducted interviews with several public health officials and experts in New York over the last couple months for the article, which can be read in full on their website. It is a poignant piece and yields responses from experts, like the one below, which are both telling and familiar sentiments around the current state of public health.

“By having a perfect storm of all three diseases circulating at the same time, it is a crushing blow to health departments,” said Lawrence Gostin, a professor of public health law at Georgetown University, referring to New York. “While this clearly should have ushered in a blaring alarm to advance our preparedness, health systems and response, the exact opposite has happened. Investments in public health have plummeted over decades.”

Banco adds that “concerns over federal support for public health come at a time when public health workers are leaving their jobs in droves.” The NPR article Banco references here explored burnout across the sector and, more specifically, the personal threats plaguing the retention of a workforce that, by its nature, demands a distinct amount of experience and qualifications.

A quick skim of all the county health department websites in Maryland does well to illustrate the layering effect of concurrent emergencies. From Allegany to Anne Arundel, above the fold on almost every home page are resource links for COVID-19, monkeypox, opioids, and mental health services. For a severe lack of a better phrase, the matrix of simultaneous threats is alive and well in Maryland’s public health community.

Funding for public health in Maryland has been declining or flat for over a decade leading up to the COVID-19 pandemic. However, the demand for resources and programs has ballooned in the wake of the opioid epidemic, the COVID-19 pandemic, and a monkeypox outbreak. Predictably, the dominoes have fallen, exacerbating the need for mental, behavioral, and environmental health programs.

It is no mystery that public health services are most effective with a preventative approach. The strength of that defense is fortified by the financial and human capital that composes it. Prevention is the long game; therefore, a lack of preparedness is undoubtedly symptomatic of predictable, short-game politics on all sides, as evidenced purely by the timeline in which the erosion of funding has spanned.

MACo has covered this progression on the blog, in testimony, and at the conference with specific citations regarding pre-pandemic funding concerns as recently as the 2019 legislative session. Additionally, the Conduit Street blog hosted a 6 post series on the issue dating back to 2011. For a particularly deep cut, check out the MACo-commissioned study from 2010 on how core funding for local health departments was imperiled after the recession beginning in 2008 and has yet to be restored. Spoiler alert, and true to MACo form, the background section of this 24-page report will launch the reader clear into the previous century.

For better or worse, the last two years have ushered in a valuable opportunity to consider lessons learned during the COVID-19 pandemic and account for shortfalls in public health preparedness, that began long before. The horizon and vantage points have undoubtedly shifted for local health departments, leaving stakeholders with a significant responsibility to decide what public health should look like in a new landscape.

Related coverage from Conduit Street:

Revive Local Health Funding Today for a Better Tomorrow

Blog Series: Local Health Departments – Part 1

Blog Series: Local Health Departments – Part 2: Services, Structure and Staffing, and Funding

Blog Series: Local Health Departments – Part 3: History of Local Health Services and Core Funding

Blog Series: Local Health Departments – Part 4: Core Funding Formula and Recent Challenges

Blog Series: Local Health Departments – Part 5: Core Funding Formula and its Shortcomings

Blog Series: Local Health Departments Part 6: Conclusions and Recommendations