We read with alarm a recent article, “Prince William tops region’s state-run health districts in staff vacancies,” in the Prince William Times, chronicling the high vacancy rate in the Prince William Health Department, the reasons for it, and the years of declining support it has received for work it does.
As witnesses to the vital work public health departments have provided over the last year to address COVID-19, the public criticism of the Prince William Health District’s pandemic response is seriously misguided.
The erosion of public support for the health district has occurred while the population has continued to increase – and where significant health disparities persist. Sadly, the lack of public support for public health is not unique to this particular health district, nor to Virginia. Nationally, public health has lost 50,000 jobs since 2008, about one-fifth of its workforce. Federal funds supporting state, local and tribal public health preparedness were also reduced by nearly $300 million – from $940 million in 2002 to $675 million in 2019, which equates to about $2 per U.S. citizen.
The COVID-19 pandemic has lifted the veil on the important role public health plays in protecting our communities’ health. We are now well aware that state and local public health departments investigate disease outbreaks. But they also provide clinical services such as immunization, health screenings, TB clinics and STD and HIV services.
Many public health departments also administer the WIC (Supplemental Nutrition Program for Women, Infants, and Children) program that provides needed supplemental food and nutrition education for low-income mothers and children. State and local health departments shepherd the community health-improvement process, assessing community needs and, in partnership with the community, identifying solutions to meet those needs. Exceptional public health departments, like the Prince William Health District, leverage those partnerships to bring additional resources to address community health needs.
Yet now, during the worst public health crisis in 100 years, there is criticism over pandemic response. The fact of the matter is that local public health department staff and leadership have worked tirelessly to contain and mitigate the impact of COVID-19, while continuing to provide essential services. Moreover, those same public health departments have been regularly starved for funding, which has led to increased vacancies and a lack of competitive salaries.
Yet, over many years, leaders at all levels of government have made decisions that have directly contributed to the conditions that public health departments are facing. That is why we feel that this is not the time to criticize crisis response and shift blame. It is time to commit to building a public health system adequately resourced to protect and promote the health of the residents of our communities.
If we take nothing else from COVID-19, it is that it has demonstrated for us that our safety, security and, ultimately, our economic prosperity are dependent on a well-financed and adequately staffed state and local public health infrastructure.
As the pace of vaccinations increases, there is a clear choice ahead – invest in public health or continue to gamble with our health and our economic prosperity.
Mathews is president and CEO of the Northern Virginia Health Foundation. Lee is executive director of the Potomac Health Foundation. Castrucci, is president and CEO of the de Beaumont Foundation.