Impact of federal and state preparedness budget cuts on infectious diseases morbidity

The purpose of this presentation is to provide a description of how changes in funding for public health preparedness may impact infectious diseases morbidity at the state level.

The Public Health Improvement Act, sponsored by Senators Bill Frist and Ted Kennedy, was signed into law on November 13, 2000 as P.L. 106-505. Title I of the Act, known as the “Public Health Threat and Emergencies Act” was intended to “strengthen the nation's capacity to detect and respond to serious public health threats, including antimicrobial resistance and bioterrorist attacks”. Funding has subsequently been made available through CDC, which has provided $800 million-$1 billion annually to strengthen public health infrastructure and capacity to respond to public health emergencies, including bioterrorism. Since 2005, however, federal funding for state and local preparedness has been cut more than 25 percent, and states are no longer receiving any supplemental funding for pandemic flu preparedness, despite increased responsibilities.

In a retrospective cohort study exploring the association of changes in local health department expenditures with changes in state-level health outcomes, 1996-2004, increases in LHD expenditures were significantly associated with decreases in infectious diseases morbidity at the state level (p = 0.037), controlling for other factors known to influence health. For each 10 percentage point increase in LHD expenditures, infectious diseases morbidity declined by 1.8 percentage points. On this basis, a 25% decrease in preparedness funding could have serious consequences regarding infectious diseases morbidity. This has important implications for public health preparedness, for both bioterrorism and routine surveillance.