Public health cuts: a prescription for poor health

Which of the following is acceptable to you, your family and your community?

— An increase in newborn and infant deaths along with a rise in child abuse due to lack of services to thousands of impacted families and pregnant women.

— An increase in measles and pertussis (whooping cough) outbreaks due to 10,000 fewer immunizations each year.

— An increase in head lice, infectious diarrhea and Hepatitis B cases for our children when hundreds of child care centers do not receive the necessary information on hygiene and safety, and prevention of infections and communicable diseases.

— An increased risk of tuberculosis and sexually transmitted diseases when thousands of high-risk individuals are not treated.

The continued and proposed cuts in public health spending from Snohomish County will result in all of the above, along with a lack of access to basic human needs such as food, housing and health-care referrals for thousands, including children. It will also severely impact our readiness to respond in the event of a health and security threat such as a flu epidemic, natural disasters or bioterrorism.

The proposed cuts along with an ever-increasing case load acuity of the public health nurses will lead to the degradation of the public safety net and an immediate impact on public safety and quality of care. Though some of the effected are the most highly vulnerable and often invisible populations, the local health department has responsibility for people of all ages, incomes and ethnic backgrounds.

Public health nurses are on the frontlines of the system and witness every day the positive impact that public health has across communities. As registered nurses, we understand and see the consequences every day of the crumbling public health system.

The community has come to rely on the Snohomish Health District and its public health nurses for many types of direct and preventative care, including:

— clinic services for immunizations, refugee screening, travel consultation, screening and treatment of sexually transmitted diseases;

— communicable disease prevention and control, as with tuberculosis and pertussis;

— prenatal health to prevent negative birth outcomes;

— parenting skills and child development education to prevent child abuse and infant mortality;

— assessment and interventions with children who have special health-care needs;

— health consultation and training of early childhood care providers; and

— assistance in accessing appropriate health care and other community services.

Many of our community partners rely on the referrals and support provided by our programs to ensure the health of our community. These include criminal justice/corrections, school districts, prenatal and health-care providers, DSHS, food banks, housing resources, mental health agencies, hospitals, child-care licensers and providers, and chemical dependency treatment and domestic violence programs. The dissolution of public health funding and services will lead to higher human services caseloads, fewer resources and higher health-care costs.

The public health system in Snohomish County, along with all of Washington’s public health system, is in jeopardy due to decades of neglect and erosion in public health spending. The ability of our local public health department to perform its core functions has been greatly reduced.

Public health is the most cost-effective system for disease prevention and health improvement. Yet, only 2 percent of the total health care dollars are spent on public health services, and Washington ranks 44th in the nation in per capita spending on public health.

Clearly, the current system is grossly inadequate. Any further cut to the system is simply irresponsible and places the community at unacceptable risk. Public health is the epicenter of a quality health-care system and is the most cost-effective system for disease prevention and health improvement. It is our first line of defense in responding to a communicable disease outbreak, bioterrorism or other health disaster.

Public health funding is a top priority for the Washington State Nurses Association and it needs to be a top priority for the people of Snohomish County and the state. We must hold public officials, at both the local and state level, accountable for restoring and increasing public health funding to ensure the health of our community. The health of our communities is very much dependent on our public health departments and public health nurses.

Public health and public health nursing is the center of a medical care system that promotes the health of our communities and plays a key role in disease prevention. If you’re not aware of their work, it’s a sign that public health departments and public health nurses are doing their jobs well.

Barbara J. Bly of Everett is chair and Mara Marano-Bianco of Mukilteo is co-chair of the Washington State Nurses Association unit that represents Snohomish County public health nurses. Bly has worked as a public health nurse for 30 years, Marano-Bianco for 13.