Public Comment

Why Cuts to Public Health Must be Reconsidered

By Vivian Lee
Monday May 02, 2011 - 04:20:00 PM

With the State's persistent budget crisis and the dwindling economy, the city of Berkeley has been grappling with an budget deficit of $12.5 million for the 2012 fiscal year. The projected $3 million budget on the Department of Public Health, announced in the recent Berkeley City Council meetings, has especially caused a heavy hit, as many employees were let go in the past several weeks, leading to an entire restructuring of the department structure to make up for the losses. While it has been the case, in fiscal crises, that public health services are among the first places to incur cuts, we must reconsider the tremendous value of public health all the more during these down-trodden times. 

As a UCSF Master's student completing my community health nursing rotation at the Department of Public Health for the past four weeks, it has been disheartening to see the drastic effects that the budget cuts have been having on the department. While my colleagues and I were warmly welcomed by the staff on the first day of our rotation, there was an unmistakeable tinge of sadness pervading the department, as staff were saying farewell to numerous coworkers whose positions were cut due to the recent budget decisions. The remaining staff shouldered a long list of public health programs that they now managed in order to fill the roles of their former coworkers. Each program provides services to tens and thousands of Berkeley residents, ranging from immunization and communicable disease control to nutrition and case management services for low-income families, pregnant women and children. Targeting those with special needs, including pregnant women, infants, children, elders, the homeless, and the disabled, these programs cater to the most needy and undeserved of Berkeley's inhabitants. As much as the staff try to make up for the cuts, we will inevitably see repercussions in the quality and quantity of time and resources allocated to these essential programs. 

Study after study has shown the cost-saving and life-saving benefits of public health programs. Investing in prevention reduces the burden of disease in the long run and decreases the amount of health care dollars spent. As a significant portion of health care costs are spent on chronic diseases such as type 2 diabetes, public health measures such as childhood obesity prevention programs will not only mitigate suffering and illness, but also save the nation significant amounts of money. 

We know the tremendous impact that public health has had in tackling all the areas of our community that influence health, such as sanitation, nutrition, transportation, safety, disaster preparedness, housing, education and safety. Public health initiatives such as mandating seat-belt use, raising taxes on cigarettes, and immunization requirements have significantly impacted the health and welfare of the public. Persistent health disparities manifesting itself in greater incidence of asthma and cardiovascular disease in low socioeconomic communities are being tackled through multi-pronged public health interventions. 

As the number of Americans that do not have health insurance is increasing and the economy continues to dwindle, we need to invest in and protect public programs that address the health of the entire community. Public health should not be the first on the chopping board, but rather the last to go. Let us not spend all of our taxpayer dollars on emergency room visits and other critical care services, but protect preventative and population-health services, which, while saving money, can also improve quality of life and prevent illness before it needs critical attention. Preserving public health programs will help us collectively rise from these economic downtimes more healthy as a whole community. Anticipating the upcoming health care reform as well as the City of Berkeley's ongoing council meetings that will conclude the budget process in June, I hope that decision makers will think twice before making drastic cuts to much needed public health services. 

Vivian Lee is a Master's in Nursing student at UCSF.