The State of Local Health Departments in 2014
By Nar Ramkissoon, MPH
“The work of local health departments is critical in protecting the health of the community.” Thomas R. Frieden, MD, MPH Director, CDC
The 2013 National Profile of Local Health Departments has just been released, and it provides some eye-opening stats on the health and well-being of 2,800 Local Health Departments nationwide. The annual study on the state of local public heath funding, prepared by NACCHO with funding by the Centers for Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation (RWJF), shows how local health departments continue to struggle financially and see a drop in employees. In spite of the many challenges, public health employees remain ever dedicated to their mission and are doing everything they can (including forming partnerships and embracing new technologies) to protect and improve the health of their communities.
The very familiar story of decreased funding for local health departments continues, as funding for programs like emergency preparedness has dropped by almost 45% over the past three years. Most concerning though is the overall financial health and the future sustainability of local health departments. Almost half of all local health departments with a reserve fund experienced a decrease in the amount of money in their reserve funds (46%) in their most recently completed fiscal year. Many local health departments face a challenging future, uncertain of where and how they will secure long-term funding.
In another all too familiar story, the local health department workforce has dropped by 28,000 employees — from 190,000 to 162,000 — over the last three years. The estimated overall local health department workforce in FTEs (full-time employees) decreased by approximately 12% from 2008 to 2013. Staffing decreases were greatest among local health departments serving large populations (500,000 or more), with median numbers of employees and FTEs decreasing by more than 10%. Local public health officials are being asked to do more with less, including taking on additional responsibilities outside their current positions and finding innovative new ways to get things accomplished.
Despite funding cuts and employment purges, the strong desire to improve the community has never left those working for local health departments. 42% of local health departments reported sharing resources to a greater extent than in the previous year, while only 2% reported sharing resources to a lesser extent. There is also a strong movement to continue to improve quality of care. While quality improvement, or QI, was a relatively new concept at the time of NACCHO’s previous report in 2010, 56% of local health departments now have formal QI plans.
Local health departments are also becoming quicker to adopt new technologies. Nearly half utilize social media, with Facebook as the overwhelming favorite. 52% have started using text messaging for communications, and 70% utilize email alert systems. A whopping 91% use smartphones and 48% use tablets.
Some examples of local health departments embracing new technologies:
- A local health department in Utah holds Facebook contests to help spread awareness
- A local health department in Illinois uses Twitter to inform their constituents on preventable disease
- A local health department in Colorado uses YouTube to help get its message out
More than just embracing new technology and devices, local health departments need to embrace smarter billing practices and electronic billing to increase revenue.
“Moving our nation toward a culture of health will require smart investments in public health and getting the highest value, most impactful outcomes from those investments.” Risa Lavizzo-Mourey, MD, MBA, President and CEO, Robert Wood Johnson Foundation
We recently launched our $100 Million Challenge to help generate $100 million dollars of new, annual revenue for local health departments. We see the innovative ideas that local public health professionals are coming up with on a daily basis to support the health of their communities.
In our challenge, we are working with local health departments across the country to discover innovative ways to capture new revenue with little impact on their budget and their time. This revenue could help provide certainty to the question of funding for next month and next year while providing security for the long-term financial future of the local health department. Call us today to learn how you can join the $100 Million Dollar challenge and generate new sustainable revenue for local health departments.