Local health departments: Time of challenge and change

摘要

The economic recession, beginning in the fall of 2008, resulted in a sharp reduction in the local public health workforce, threatening the capacity of these agencies to provide vital services to communities throughout the nation. At the same time, these funding shortfalls are causing an examination of the structural and organizational options for local agencies. In this issue of the Journal, Willard and colleagues1 studied the period between 2008 and 2010 by conducting 3 Web-based surveys of a nationally representative sample of local health departments (LHDs). These surveys administered by the National Association of County & City Health Officials revealed that by 2010, 53% of these agencies experienced reduced core funding. In 2009 alone, 23 000 jobs or 15% of the local public health workforce were eliminated. As described by the authors, these cuts have been inflicted on LHDs already weakened in the previous decade by substantial reductions in funding.