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A new report finds Iowa’s public health systems have improved their rankings and now are well-prepared for a range of emergencies.
The annual report published by nonprofit health policy think tank Trust for America’s Health showed Iowa improved in its ratings this year, moving up from the middle tier to the top team. Iowa was among 12 states that improved the performance ranking.
However, despite Iowa’s and other states’ success in emergency preparedness, the report also highlights the impact that underfunding and undermining public health officials’ authority during the COVID-19 pandemic has had on public health, the researchers say.
“After two decades of funding numbers generally going in the wrong direction for public health agencies, we would hope the pandemic would be the wake-up call policymakers need to go in the right direction,” said Dara Lieberman, director of government relations at Trust for America’s Health.
The 2022 report measures states’ readiness to respond to health emergencies using certain indicators, such as disease surveillance, ability to expand health care services during emergencies, safe water and more.
Based on these metrics, 17 states — including Iowa — and Washington, D.C., ranked in the highest performance tier. Another 20 states ranked in the middle tier, and 13 fell in the low tier. This year’s report measures each state’s performance during 2021.
Overall, the researchers found the majority of states have preparations in place to expand health care care and public health capacities in the event of an emergency.
This year’s report highlights the importance of investment in public health systems following 2021, which nationally saw extensive flooding, an active hurricane season and unusual December tornado activity. That’s all in addition to the deadly coronavirus pandemic that has killed more than 900,000 people in the United States.
Public health funding increased in Iowa, according to the report, rising 9 percent between fiscal 2020 and fiscal 2021. This comes after two years of funding cuts, with Iowa reporting a 3 percent decrease in fiscal 2020 and a 1 percent cut in fiscal 2019.
It’s critical federal and state governments invest in public health infrastructure and workforce to ensure agencies are prepared for the next disaster, Lieberman said. Just as the government invests in the military to protect the country, elected officials need to better fund public health agencies to enable them to better protect against the spread of disease or other factors that can impact the overall health and safety of communities.
Currently, she said, funding that is distributed to agencies usually is sent in silos, limited what those dollars can be used for, which can hinder effective public health response.
“The public health system is people and labs detecting disease, trying to contain them before it becomes something as devastating as a pandemic,” Lieberman said. “Yet we are asking the public health system to respond to a 21st century threat with 20th century tools.”
The report found residents in only a handful of states benefit from a robust public health system — systems that were further undermined during the ongoing pandemic response, according to researchers.
“During the early stages of the pandemic, the federal government lacked an evidence-based leadership role in the pandemic response, and science and public health expertise were often not heeded,” the report states.
In Iowa, only 38 percent of the state’s population was served by a comprehensive local public health system in 2021, the report stated. That includes agencies’ capabilities to provide basic services that are the core of a public health infrastructure.
Across the United States, only about half of the nation’s population has a comprehensive public health system in their communities.
Public health officials are leaving the profession in droves, with some national reports tallying more than 500 public health officials nationwide leaving the field since March 2020.
“Underfunding contributed to understaffed and overworked health departments using out-of-date technologies,” the report states. “In addition, lack of support and outright threats against public health officials contributed to hundreds of senior-level state and local public health officials leaving the profession.”
It’s unclear what the impact in Iowa has been so far, but officials across the state are concerned that burnout may result in professionals seeking other employment or early retirement from their current roles. According to a statewide survey in late 2020, 34 percent of Iowa’s county public health administrators are between the ages of 55 and 64.
To read the full report by Trust for America’s Health, visit tfah.org.
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