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Originally published April 10, 2009 at 2:37 PM | Page modified April 10, 2009 at 4:35 PM

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Guest columnist

Preserve public health infrastructure

Public health care is important infrastructure to a successful society, argues Laura Hitchcock, executive director of the Washington Public Health Association. In this difficult state economy, the Washington state Senate's budget, while it has some cuts for public health, does not endanger the underpinnings of this important community asset.

Special to The Times

OUR former U.S. surgeon general, C. Everett Koop, once said that: "Health care is vital to all of us some of the time, but public health is vital to all of us all of the time."

Across the country, communities are optimistic this year about the role that public health can and will continue to play in keeping our communities safe, especially as we focus on health-care reform and face an economic recession.

But, with the proposed Washington state budget introduced by the House of Representatives last week, it's not clear whether we will have similar cause for optimism about the public's health here in our state.

Two years ago, a highway bridge in Minneapolis collapsed, sending cars and trucks plunging into the Mississippi River. Afterward, investigations revealed that thousands of bridges were cracked and in danger of collapse, and a public outcry resulted in attention and investment in this important part of our road system.

Another set of invisible cracks exist — cracks equally likely to seriously injure or even kill people. Similar to our nation's bridge and highway infrastructure, our public-health system is in need of renovation and rejuvenation, with a steady funding source that currently does not exist. A two-year bipartisan study found $300 million dollars of deficiencies in the system and recommended an immediate investment of $100 million. Since then, $32 million has been cut from the system, along with more than 250 workers statewide.

The House of Representatives' budget as introduced April 1 will create a shocking $41 million hole for core public-health funding, in addition to cutting millions more out of key programs. Hundreds more public-health professionals across the state will lose their jobs. Just like cracks in a bridge, this hole is bound to make parts of our system fail.

So what is in danger if we allow our system to be eroded? This year, an estimated 10,000 public health professionals across Washington are working in their communities immunizing children against preventable, sometimes deadly diseases through our state's Universal Vaccine Program, promoting policies and inspecting workplaces and restaurants to ensure safety, sanitary conditions and prevent outbreaks of diseases such as E. coli, and helping to control infectious diseases through education, treatment and planning (think HIV, pandemic flu, tuberculosis), and preventing chronic disease through treatment and education (helping people to quit smoking, and curb obesity, for example). They also visit new moms who are at risk of failing to care for their infants through an effective home-visiting program.

Not only are these programs and investments necessary and protecting hundreds of thousands of people from illness and death, they have been cost-effective, meaning that prevention was cheaper than paying for long-term treatment or medical problems. In many cases, public-health workers are the very real line between a small outbreak of a disease and a communitywide epidemic with thousands of deaths.

In contrast to the House proposal, the state Senate budget is more responsible. While making some cuts to public health, it preserves basic funding and keeps our system whole.

Legislative leadership must recognize that the fissures in our public-health system cannot be allowed to grow during this time of economic hardship. And playing a shell game with funding sources without genuinely preventing budget cuts is not an appropriate way to protect the public.

With thousands of uninsured people in our state, and likely significant cuts to the state's public insurance programs, now is the very time when public-health programs that provide education, prevent disease, and plan for epidemics and other emergencies need to be funded as core functions in state government.

We urge our elected officials to save public health by adopting the Senate's approach in the final budget negotiations and finding sustainable funding sources. Save public health — these cuts can kill.

Laura Hitchcock is executive director of the Washington State Public Health Association.

Copyright © 2009 The Seattle Times Company

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