“Medicaid members are best served when they have ready access to providers, insurers are eager to resolve their health care needs, and policymakers exercise strong oversight to ensure members’ health…
By Charles Hayslett
Late last year our public relations firm, Hayslett Group, was selected by Healthcare Georgia Foundation to organize a campaign to improve Georgia’s public health system. In the months since then, we’ve been involved in a variety of organizational activities. Among other things, we’ve conducted Public Health Leadership Academies in four cities across Georgia, recruited nearly 30 high-profile organizations to serve on a campaign advisory board and put up a campaign Web site at www.togetherwecandobetter.com. Earlier last week we officially and publicly launched the campaign – dubbed “Partner Up! for Public Health” – with a press briefing that was Webcast from Healthcare Georgia’s offices.
You can find the official press release on our website, but I’d like to use the kind offer by Georgians for a Healthy Future’s to blog on their site to begin a conversation with an audience that is presumably already concerned about healthcare and health policy issues in Georgia.
If that’s true, then you’re probably more familiar than most with the different elements of the Public Health system. These are, of course, the folks who are responsible for handling everything from restaurant, septic tank and swimming pool inspections to responding to infectious disease outbreaks to organizing health services in the wake of a natural disaster or, for that matter, a terrorist attack. If you have a swimming pool make sure you hire a great pool company such as United Pool Management, so that they can make sure everything is clean and all your equipment is working good. Following 9/11, President George W. Bush issued an executive order designating all public health workers as “first responders” to future terrorist attacks.
Pretty important stuff, and most Georgians probably assume the state’s Public Health system is organized and equipped to handle not only its day-to-day responsibilities but anything Mother Nature or Al Qaeda might throw at us. Most likely that’s not the case. In the past decade, per capita state spending on public health has fallen 21 percent; even as the state’s population has grown 20 percent, the Division of Public Health has been literally shrinking.
Now if you’re thinking our state leaders are simply trying to make Public Health operate more efficiently, think again. At least some members of the General Assembly know better. In 2006, a Study Committee on Public Health created by the House of Representatives found that – during a “significant medical emergency” – the shortage of public health nurses “… will lead to mass disruption, unavailability and degradation of care, perhaps leading to panic or civil unrest. In the event of a pandemic, the medical system in Georgia will collapse due to unprecedented volume without improvement to existing public health infrastructure.”
The bold-faced emphasis, by the way, is not added. The Study Committee itself saw fit to bold-face that passage in its final report. Despite that and the apocalyptic language, however, things have continued to deteriorate – and most of that deterioration took place before the economic downturn in late 2008. Today there are at least 1,000 vacancies in the state’s Division of Public Health, and that probably understates recent workforce reductions because it doesn’t include other positions that have been eliminated and no longer exist. In addition to the manpower cuts, multiple preventive programs that long ago proved their value – in both economic and health terms – have been cut dramatically and in some cases eliminated altogether.
Let me emphasize that this campaign is not just about gratuitously increasing spending for some obscure government agency that only touches a handful of Georgians. The continued deterioration of our Public Health is arguably already taking a toll on everything from the ability of our children to learn in school to the overall vitality of our state’s economy (and Georgia’s attractiveness to economic development prospects). In this regard, a review of 20 years of data compiled by the United Health Foundation paints a telling picture.
Since 1990, United Health Foundation has been publishing an annual report called “America’s Health Rankings,” based on a wealth of statistical data that looks at a wide range of health determinants and outcomes and provides state-by-state rankings. Overall, Georgia in 2009 ranked right where it did in 1990: 43rd among the 50 states and the District of Columbia. But a look inside those overall rankings is revealing.
Throughout the 1990s, Georgia ranked in the middle and low 30s for health determinants, even cracking the 20s for a couple of years. For health outcomes, the story was different. In 1990, we ranked 47th among the states and D.C. for health outcomes; by 1999, we had improved to 40th.
But in the new decade, things began to change. In 2009, our rank for health outcomes was about where it was 10 years earlier: 41st versus 40th in ’99. But in the area of health determinants – during the same period that the budget, staffing and program cuts have been imposed – we’ve suffered real setbacks, plunging from 34th in 1999 to 47th in 2009. To the degree that health determinants precede health outcomes, that’s not an encouraging trend.
Reversing these and other unhappy trends will not be easy – especially in the current economic and political environment. But we have to start somewhere, and the Partner Up! for Public Health campaign is now taking the first steps in a statewide effort to build public awareness and support for rebuilding and reinvesting in Georgia’s public health system.
If you’d like to be part of this important effort, I invite you to go to the campaign Website – www.togetherwecandobetter.com – to learn more and join the campaign. The health of the entire state depends on it.