Meadville Tribune

June 18, 2013

Health services severely affected by sequestration

By Nina Bell
Eye on Public Health

— As most of us are aware, sequestration has had an impact on a variety of national resources that provide vital services to our country. The cap on spending affected defense and nondefense discretionary programs, including many public health initiatives. Over the next 10 years, $1 trillion will be cut from such programs because Congress failed to pass a balanced deficit reduction plan.

In the world of public health, there are substantial cuts to every state’s public health initiatives. Here are the key facts when compared to funding levels from 12 years ago, noting that the numbers are adjusted for inflation and population growth:

- Health Resources and Services Administration: $2 billion reduction. This reduces the health workforce, which exists to support training new health professionals.

- National Institutes of Health: $1.2 billion reduction. This reduces the amount of funding for critical health research such as cancer and diabetes cures.

- Substance Abuse and Mental Health Services Administration: $813 million reduction. This cut will affect successful smoking cessation programs as well as critical mental health services for low-income groups. This could mean that close to 373,000 seriously mentally ill adults and children will go untreated, leading to increased hospitalizations, criminal cases and homelessness.

- Head Start: $968 million reduction. According to the Education Subcommittee on Appropriations, over the last decade there have been struggles with a significant shortfall from this early childhood education program that eliminated thousands of enrollment slots across the nation. This additional cut will likely result in turning away children who could benefit from Head Start programming in the state.

- Child Care and Development Block Grant: $592 million reduction. This means that only one in six children will be eligible for child care assistance when far more than that require help. According to the Education Subcommittee on Appropriations, child care remains one of the biggest challenges for working families.

- Centers for Disease Control and Prevention: $122 million reduction. This affects a plethora of programs from environmental health and immunization to emergency response and preparedness to global health.

The most recent sequestration hit the CDC the hardest, causing a $580 million reduction in the centers’ 2014 operating plan. No program went unscathed, as the following areas will see reduced funding:

- Immunization and respiratory research

- HIV/AIDS, Hepatitis, STI and TB prevention

- Emerging and Zoonotic (animal-transmitted) infectious diseases

- Chronic disease prevention and health promotion

- Cancer prevention and control program

- Birth defects, developmental disabilities, disability and health

- Environmental health

- Injury prevention and control

- Scientific services (surveillance, informatics, career development)

- Occupational safety and health

- Global health

- Emergency response and preparedness

One of the hardest hit areas was the childhood immunization program, which took more than $1 million in cuts from 2013 to 2014. This could essentially create issues with the start of the school year in 2014 when required immunizations will not be as easily accessible to low-income groups.

In addition, the cuts affect food safety programs and up to 2,100 food inspection jobs could be lost, putting families at risk of foodborne illnesses. Furthermore, this cut coupled with the reduction in emergency response and preparedness funding could open the door to easier bioterrorism attacks via the nation’s food supply.

The list of issues goes on and on because of the impasse and the exceptionally high national debt. The impact will be nationwide with both services and personnel being cut. The NDD United (with NDD meaning nondefense discretionary) created a video that explains the cuts. You can access it at nddunited.org.

There has been a solution on the table through The Prevention and Public Health Fund, created under the Affordable Care Act. This fund had the potential to sink billions of dollars into public health and prevention services. According to the ACA, the fund is to provide $18.75 billion from 2010 to 2022 and then $2 billion per year after that. Unfortunately, a February 2012 piece of legislation cut that $18.75 billion over 12 years to $6.25 billion over nine years. Further reductions were made thanks to sequestration.

Bell, Ph.D., MPH, is a public health professor with Ashford University and works in health promotions for the Meadville Family YMCA. You can email her at nina@w2w4life.com.