Tough Economic Times: The Impact of Budget Cuts on Local Public Health

Over the past year, a large proportion of local health departments (LHDs) have experienced budget cuts. As a result, in 2008 more than half of LHDs had to either decrease their workforce or lose staff through attrition, and have been unable to replace them due to budget limitations. Budget cuts at the local level may have implications for LHDs' ability to provide needed services. As the membership association for LHDs, the National Association of County and City Health Officials (NACCHO) has unique access to the knowledge and experiences of local public health practitioners. Using NACCHO's 2005 and 2008 National Profile of Local Health Departments data and recent Survey of Local Health Departments' Budget Cuts and Workforce Reductions, we will share our findings from a multivariate analysis of changes in LHD budgets between 2005 and 2008 and corresponding changes in number of services provided by LHDs. The multivariate analysis will use the amount of budget decreased as the independent variable and the change in number of services provided as the dependent variable, while controlling for appropriate covariates. Our preliminary analysis shows that 27% of LHDs experienced a budget decrease in the current year compared with the prior year and this percentage shows considerable variation across states and categories of jurisdiction population. We expect to find that LHDs that experienced the largest budget cuts will have been forced to reduce a proportionately greater number of services. These findings will shed light on allocation of resources to LHDs and inform future advocacy efforts.