Rhea Farberman, TFAH Director of Strategic Communications and Policy Research

Decades of underfunding have left the US public health system ill-equipped to handle emergencies, according to a new report by the Trust for America's Health. The report highlights a boom and bust cycle of funding, with attention and investment in public health only occurring during emergencies. This has created gaps in the public health infrastructure, making the nation less prepared to respond to future emergencies. The report calls for sustained and increased funding, modernization of data systems, and expansion of the public health workforce. The full report can be accessed on the Trust for America's Health website. Decades of underfunding apparently have left the nation's public health system rather ill-equipped to protect our health and prepare for future emergencies. And this is according to a brand new report that is just going to be released and made public today. It is called The Impact of Chronic Underfunding on America's Public Health System, Trends, Risks, and Recommendations 2023. And it's being released by an organization called the Trust for America's Health. And joining me with some information about what is available in this report is the group's Director of Strategic Communications and Policy Research. We have Rhea Farberman who is with me here this morning at RNJ. Rhea, good morning. It's Burt Barron, WRNJ Radio in the great state of New Jersey. How are you? I'm good, Burt. Thanks for having me. My pleasure, Rhea. We do take healthcare and we do take our health and well-being here in New Jersey very seriously. So I thank you for having RNJ Radio get this information out nice and early today to the listeners here in our state. Can you just share a couple of the key findings of this report? And there's probably a couple of rather alarming things that I'm sure you came across. You want to share some of the key findings? Sure, happy to. We've done this report for now two decades. And we have found a pattern of underfunding public health, a boom and bust cycle is how we describe it, where we invest in public health and pay attention to the system's needs during an emergency, but only during an emergency. And once an emergency is managed, we go back to a pattern of underfunding the system. And that has left serious gaps in our public health infrastructure, which make us less prepared to respond to emergencies. Well, we just went through, obviously, a years-long pandemic, which I hope in my lifetime, I hope we never have to deal with that again. And here in our part of the country, Rhea, here in northwest New Jersey, one week ago today, I'm telling you, you couldn't even go outside and breathe because of all this wildfire smoke from Canada that was basically blanketing our entire area. It was like you couldn't even see 20, 30 feet in front of you because of this thick smoke and this really dangerous situation that we had. So why do we continue to have these cycles where we fund, then we don't fund, then we get back to it, and then we kind of back off a little bit? How do we break the cycle? And is there a way to do so? Well, that's the reason for our report and the reason that we're going to continue to do this report annually and talk about it as much as we can. We need to get policymakers' attention that they need to invest in public health on a sustained basis, year in and year out. The system needs increased funding, it needs sustained funding, and it needs flexible funding. You mentioned that smoke event last year. I live in Maryland. We had it also, not as severe as the New York, New Jersey area. But it goes to show that public health systems need to be prepared for a spectrum of emergencies. We had COVID, which was a tragedy with the number of lives lost. We had this smoke event. There's also an increase in other types of infectious disease outbreaks. There's an increase in chronic disease in this country. And weather events are becoming more frequent and more intense. So we need to invest in a public health system that has the capacity to respond to whatever the next emergency will be. My guest here at the RNJ Morning Program is with the Trust for America's Health, and she serves as the Director of Strategic Communications and Policy Research, Rhea Farberman, with some really good information that's being shared here at the RNJ Morning Program. I don't know how it is for other states around the country, Rhea. I focus largely on my home state here in New Jersey. Of our 21 counties, I know everyone has their own county health department. They all have their own priorities. New Jersey is such a diverse state that maybe what's a priority in one county isn't even given a second thought in another county. But I'm guessing that all of these different counties in the public health departments all play a role specifically in the overall health of our state. Is it a collective thing where each county kind of plays a role in just making us the healthiest place that we can possibly be? Yes. You're really onto something there, Bert. The public health system nationally is a network of health departments. We have national public health and CDC is the leader there. By the way, CDC is the primary funder of public health dollars that go down to, funnel down to states and counties. Making sure that CDC has an adequate budget is critical. Then states also fund their own state departments and county departments as well. Making sure that there is appropriate funding at every level and coordination between these levels is incredibly important. One of the couple of unique things regarding New Jersey is, first of all, we're the most densely populated state in all of America. We have the most people per square mile. But when you break it down and you look at, we have, for example, we have certain municipalities in one county that have more people in that one town than you'll find in the entire population of another county combined. So it's really just a unique landscape that I think we have here in New Jersey and a diverse one. And we always, of course, worried about making sure that resources and access to public health continue to be a priority. Are there any recommendations, Rhea, that you think are going to see as a result of this report being issued today, whether it's at the federal, the state, the local level? What's next in terms of maybe altering or improving the policy? Where do we go from here with this report now being issued today? Well, the most important thing is increased funding and sustained funding. We need to break this rollercoaster pattern of lots of dollars going to public health during an emergency rather than before the emergency. You know, we like to think about making the analogy between when you're fighting a fire, you don't train your personnel and buy your hoses when there's a fire. You do that before the fire. The same thing has to happen within the public health realm. We need to invest in public health infrastructure. We need to modernize our data systems so we can track diseases early and know where resources are needed. We need a larger public health workforce. One report estimated that we need to hire about 80,000 additional full-time equivalent positions in the public health system to make it able to meet local and national public health needs. So funding is a very big issue. Modernizing data systems, increasing the size of the public health workforce, I would say, would be the top priority. All great information. If someone wants to view this report for themselves, and, Rhea, I do want to take a look at it myself selfishly. I'm just going to skip right to the New Jersey part, if that's okay. But if someone wants to take a look at this report, how do they do so? Yeah, I recommend looking at it. It's on our website. We are, again, we are Trust for America's Health. Our URL is tfah.org, and the report's available right on our homepage. All right. We'll be sure to take a look at that. Rhea Farberman, the Director of Strategic Communications and Policy Research for the TFAH, the Trust for America's Health. Thank you for the time, for the information this morning. Have a healthy day, and thank you again so much. Thank you. Appreciate you having me.