First responders load a patient into an ambulance from a nursing home where multiple people have contracted COID-19 on April 17, 2020 in Chelsea, Massachusetts. Chelsea has the highest concentration o
Scott Eisen/Getty Images)

The U.S. public health system may face more budget cuts despite being starved of resources for decades. The news comes amid shortages of necessary medical equipment needed to confront the COVID-19 pandemic.

According to a report by the Associated Press, state and local healthcare workers receive very little pay despite fighting on the frontlines against a virus that has infected more than 2.7 million and killed over 130,000 people in the United States alone. Employees of the public health system are also responsible for tracking the virus using paper records. They work seven-day weeks with little time to rest for months.

Since 2010, budgets allocated for state public health departments dropped by 16 percent per capita. Local health departments also faced an 18 percent cut on spending. The country's health system operates on a skeletal workforce after the 2008 recession saw the loss of at least 38,000 jobs in state and local public health sectors.

An analysis conducted by Kaiser Health News (KHN) and AP revealed the system is underfunded on every level. The hollowed-out health departments led to an ill-equipped and slow response to the virus.

Budget Cuts

More than half of all Americans live in states that spend less than $100 per person on public health-including Louisiana, which spends $32 per resident annually, according to the analysis. Other starved states include:

  • Indiana ($37)

  • Maine ($41)

  • Missouri ($50)

  • Nevada ($36)

  • New Mexico ($36)

  • Ohio ($43)

  • Pennsylvania ($39)

  • South Dakota ($33)

  • Tennessee ($37)

The study also showed states like Florida only allocates 2 percent of state spending to public health. In North Carolina, Wake County's public health system only has 614 people on its workforce despite a 30 percent increase in its population.

In Detroit, the city's bankruptcy proceedings led to the disbandment of the health department. Today, only 200 workers are left to serve over 670,000 residents.

Low Wages

A 2019 report from the Association of State and Territorial Health Officials and the de Beaumont Foundation showed more than a fifth of all public health workers earn only $35,000 or less a year.

The published report also revealed half of U.S. public health workers spoke of plans to retire or resign from their positions within the next five years. Most listed poor pay as the top reason.

Most people with training, a bachelor's or master's degree, choose to work in the private health care sector where wages are higher, effectively sapping the public health system of promising recruits.

In Alaska, the public health's spending dropped by 9 percent, with staffing falling to just 426. A state health official said declines in oil prices forced the state to scale back on public health services. The cuts affected reproductive health services, and well-child exams for children over 6.

Since the start of the pandemic, Michigan cut most of its healthcare workers' hours by a fifth. In Pennsylvania, the local government required dozens of its 1,200 public health employees to take a temporary leave. In Knox County, Tennessee, over 26 of its 260-strong workforce were furloughed for two months.

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