Initial 2013 Profile Study Shows Slow Economic Rebound at Local Health Departments

9-11-13By Sarah Newman, MPH, Research and Evaluation Analyst, NACCHO

NACCHO periodically surveys a representative sample of America’s 2,800 local health departments (LHDs) to measure the impact of the economic recession on LHDs. This year, we included questions regarding budget cuts, job losses, and program reductions as a part of the 2013 National Profile of Local Health Departments (Profile) Study conducted from January to March. We are pleased to release findings on the impact of the economic recession on LHD jobs, budgets, and programs.

While the country as a whole shows signs of economic recovery, survey findings show that LHDs remain challenged to recover from the recession. Job losses and program cuts are beginning to taper, but LHDs are not rebounding yet.

Almost half of all LHDs (48%) reduced or eliminated services in at least one program area in 2012. Certain programs have been consistently impacted each year since 2009. Specifically, maternal and child health (MCH) and emergency preparedness (EP) services are among the most frequently affected: MCH services have been among the top three most frequently reduced programs in all six economic surveillance surveys NACCHO has conducted since 2009, and EP services have been among the top three most frequently reduced programs in four of the six surveys.

For every program except immunization, the percentage of LHDs reporting a reduction in program services they provided was smaller in 2012 than in 2011. But many programs are operating at diminished capacity, and LHDs will only be able to serve their communities by expanding programs, not by merely avoiding further cuts.

Since 2008, LHDs have shed nearly 44,000 jobs. In 2012, job losses and gains were roughly equal, with LHDs adding 4,000 positions and reducing 4,300 positions. But almost half of all LHDs (41%) experienced some type of reduction in workforce capacity.

A similar story emerges when we look at LHD budget cuts. More than a quarter (27%) of LHDs reported budget cuts in 2012. This represents a sizeable drop compared to the percentage of LHDs reporting cuts in previous years, and reflects cuts observed in December 2008. But while budget cuts are beginning to taper, LHDs are a long way from returning to the capacity at which they were operating before the recession began. LHDs are still more likely to report budgets cuts than budget increases (23%).

While job, budget, and program cuts were not as severe in 2012 as we have seen in the previous years NACCHO has conducted this study, economic growth at LHDs is still stagnant. As federal policymakers weigh further cuts, these data can be used to paint a picture of the challenges LHDs face in keeping their communities healthy and safe. Read the summary report for more details.

Have you shared the results from the job losses and program cuts survey? Tell us about it in the comments section.

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