Pandemic lays bare the starvation of public health departments; Ky. spending per resident fell 32% from 2010 to 2018, story says

Red indicates more spending on police; blue indicates more on non-hospital health.

“The U.S. public health system has been starved for decades and lacks the resources to confront the worst health crisis in a century,” begins a comprehensive story by reporters for The Associated Press and Kaiser Health News. And Kentucky is a prime example.
From 2010 to 2018, the state’s non-hospital public-health expenses per resident dropped 32 percent, more than any state but South Carolina and Nevada, which dropped 55 and 33 percent, respectively. However, the state remained stable on staffing per resident, and it had many more counties that spent more on non-hospital health than they did on police. Kentucky has a relatively low crime rate.

“State and local government health workers on the ground are sometimes paid so little, they qualify for public aid,” the story says. “They track the coronavirus on paper records shared via fax. Working seven-day weeks for months on end, they fear pay freezes, public backlash and even losing their jobs. Since 2010, spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%.”

That shows at the Kentucky River District Health Department, where Public Health Director Scott Lockard “is battling the pandemic with 3G cell service, paper records and one-third of the employees the department had 20 years ago,” the story reports. “He redeployed his nurse administrator to work round-the-clock on contact tracing, alongside the department’s school nurse and the tuberculosis and breastfeeding coordinator. His home health nurse, who typically visits older patients, now works on preparedness plans. But residents aren’t making it easy on them.

“They’re not wearing masks, and they’re throwing social distancing to the wind,” Lockard said in mid-June, as cases surged. “We’re paying for it.”

The crisis has been long in the making, the story says: “Over time, their work had received so little support that they found themselves without direction, disrespected, ignored, even vilified. The desperate struggle against covid-19 became increasingly politicized and grew more difficult. States, cities and counties in dire straits have begun laying off and furloughing their limited staff, and even more devastation looms, as states reopen and cases surge.”

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