Stronger Together: ASTHO and NACCHO Team Up for Public Health Advocacy

February 11, 2020 | Adriane Casalotti, Carolyn Mullen

The work of public health is often invisible. It is only when there is a disaster or outbreak that the safety net of public health becomes apparent. In our daily lives, we rarely consider the safety of the food we eat, the air we breathe, or the water we drink. But our nation’s public health system is, at its core, a partnership between federal, state, and local governments. That is why again ASTHO and the National Association of County and City Health Officials (NACCHO) will host a joint public health advocacy day to bring these messages to elected officials from across the country on Capitol Hill in Washington, D.C. this month. Along with members of the Big Cities Health Coalition (BCHC), numerous State Associations of County and City Health Officials (SACCHOs), and the National Association of Local Boards of Health (NALBOH), state and local public health leaders will educate policymakers about the need for increased federal funding for public health departments. This includes both support for key public health programs, but also for the broader governmental public health infrastructure—especially its workforce.

In our current moment that has us dealing with the novel coronavirus outbreak overseas, illnesses and death caused by vaping, or the recurrence of measles in communities across the country, we see just how important the work of our public health system is to the safety and security of our nation. However, it is also in these crises that we recognize the chronic under-funding of our governmental public health system. That is why we are joining together as one public health voice to illustrate the need for Congress to support strong public health workforce legislation and provide sustained, predictable, and increased funding for public health across the spectrum.

What’s in store for ASTHO and NACCHO members during this year’s Public Health on the Hill?

ASTHO, NACCHO, BCHC, numerous SACCHOs, and NALBOH members will have the opportunity to network, learn, and spread shared messages regarding the importance of governmental public health. We will host a joint breakfast, where members of Congress and their staff can meet informally with their public health officials before their official meetings. After that, public health leaders will embark on nearly 200 meetings with key members of Congress and their staff.

It is the perfect time to be here: right now, members of Congress are putting together the budget for the upcoming fiscal year—so we are sure they will want to learn more about preparedness and response efforts in their states and communities. By working in coalition, we can amplify our messages to new and veteran lawmakers alike.

What are some of your biggest policy and program priorities this year?

Our shared priority this year is encouraging Congress to increase funding for the entire public health system through the annual appropriations bill. While right now there is an intense focus on the preparedness and response efforts to coronavirus, it is important to remember that public health functions as an entire system, whether there is a well-known public health emergency or not.

Over the past couple of years, our members have faced the opioid epidemic, vaping deaths and illnesses, measles outbreaks, and now an outbreak overseas. While we appreciate increased investments for emergency scenarios—and it is certainly needed as states and localities prepare for and respond to the novel coronavirus—that is a band aid. What is really needed is increased funding across all of public health so that it is ready and able when any challenge arises. These types of emergencies strain the entire public health system, and when we pull funding from one area to address another disease it doesn’t help achieve our goal of protecting and promoting the health of all Americans.

Workforce is the backbone of governmental public health, but it in the middle of a great shortage. Why is that such a critical problem, and how can Congress help?

Governmental public health was hit hard by the Great Recession, and while much of the rest of the public sector workforce has recovered or grown, local and state health departments have not. In fact, local and state health departments have lost nearly a quarter of their workforce since 2008, shedding over 50,000 jobs across the country. This deficiency is compounded by the age of the public health workforce — almost a quarter of health department staff are eligible for retirement. Between those who plan to retire or pursue jobs in the private sector, projections suggest that nearly half of the local and state health department workforce might leave in coming years. At the same time, competition with the private sector, low pay, and geographic challenges contribute to a difficulty recruiting new talent with key public health skills. Combined, these forces indicate a public health workforce crisis that must be addressed.

While we face new public health challenges all the time, the nation is also positioned to make incredible progress in addressing long¬standing public health problems. But health departments need the people to make a difference.

Why are these Hill Days so important to both organizations, and how can members get involved if they can’t make it to Capitol Hill?

Opportunities to engage with members of Congress and their staff in Washington, D.C. is one of the most important ways to build relationships with the federal delegation. By fostering a relationship with members of Congress, our members can build that bridge of trust so policymakers know who to call when they have questions, need additional information, or need to better understand the impact of federal policy proposals.

If ASTHO and NACCHO members are not able to come to Washington, D.C. we do encourage them to reach out to their delegation and invite members of Congress to meet with them at the state or local health department, go on a tour of the local facility or just pick up the phone and call the health legislative assistants. Both ASTHO and NACCHO have advocacy toolkits which provide information on how best to schedule these types of interactions.