Public Health Funding Policy Activities

After decades of under-investment, our public health system lacks the resources it needs to tackle the full range of health threats, from potential chemical or biological attacks, to serious chronic disease epidemics, or emerging infectious diseases like avian influenza. As the lead federal agency for protecting the public's health, the Centers for Disease Control and Prevention's (CDC) budget must reflect the vital role it plays in the lives of every individual, every day, and its increasing responsibilities for homeland security.

Position Statements and Letters

Testimony

Testimony of Jeffrey Levi, PhD, Executive Director of Trust for America's Health Before House Energy & Commerce Subcommittee on Health (March 2009)
TFAH Testimony in Support of Reliable Funding for Public Health

Testimony of David Fleming, MD, Director of Public Health for Seattle-King County, Washington & Member, Board of Directors, Trust for America's Health, before to United States House of Representatives, Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education and Related Agencies (March 2008)
TFAH Testimony on FY09 Budget

The Fiscal Year 2011 Budget

America faces a major health crisis. Tens of millions of Americans suffer every day from chronic diseases like cancer, diabetes, and Alzheimer's that rob them of health and quality of life. And, our nation is not adequately prepared to respond to large-scale health emergencies or bioterrorist attacks. Quality, affordable health care is essential, but a strong public health system focused on prevention must also be part of the solution. To bolster the public health system, Trust for America's Health (TFAH) encourages increased support for a number of programs:

Pandemic Influenza Preparedness and the Biomedical Advanced Research and Development Authority:
Ensure full funding for pandemic influenza preparedness and the Biomedical Advanced Research and Development Authority (BARDA). This includes providing funding for ongoing agency pandemic preparedness activities, as well as funding for research on additional countermeasures through BARDA. TFAH supports:

$156 million for CDC, $45 million for FDA, $35 million for NIH, and $66 million for the Office of the Secretary, to expand international and domestic surveillance and detection capabilities, including the identification of vaccine virus strains; identify emerging viruses with pandemic potential; accelerate research and development of rapid diagnostic tests; improve pandemic preparedness and response, as well as our ability to contain a potential pandemic; and support international efforts to strengthen vaccine manufacturing infrastructure, expand surveillance systems, and improve pandemic influenza preparedness and response capabilities.
$500 million for BARDA to support research on additional countermeasures for biological threat agents, volatile nerve agents and radiological and nuclear threats. Funding will be targeted to countermeasure development in the high priority areas of anthrax, enhanced biothreats and acute radiation syndrome.

Global Health:
Enhance our disease surveillance capacity and ability to rapidly respond to emerging health threats. Through integrated disease surveillance, prevention and control activities, CDC's Global Disease Detection (GDD) Program aims to recognize infectious disease outbreaks faster, improve the ability to control and prevent outbreaks, and to detect emerging microbial threats across the globe. TFAH recommends funding levels of:

$56 million for the Global Disease Detection Program (GDD) to increase the number of GDD centers and expand capacity at existing Centers. Funding would bring four existing centers to full capacity, provide support for two basic centers and establish four additional developing centers.

Emergency Preparedness:
Provide funding to upgrade state and local public health departments' capacity to respond to terrorism and improve the nation's ability to respond to mass casualty events, such as the recent H1N1 influenza pandemic. Preparing for future outbreaks will require predictable and ample long-term funding for infrastructure, staffing, enhanced laboratory capacity, and training. TFAH recommends:

$761.1 million for CDC's State and Local Preparedness and Response Capability to continue to develop the capabilities necessary to detect and respond to a public health emergency, as well as for research, measurement, and evaluation.

The Public Health Workforce:
Strengthen the public health workforce and particularly bolster the workforce in state and local health departments, which are experiencing major workforce shortages. TFAH supports a funding level of:

$10 million for CDC's Health Prevention Corps, as proposed in the President's FY 11 budget, to address workforce shortages in state and local health departments.

Chronic Diseases
Provide additional resources to help combat chronic diseases, which are responsible for seven out of every ten deaths and three-quarters of healthcare spending in the U.S. TFAH recommends:

$20 million for the Big Cities Initiative at CDC, as requested in the President's FY 11 budget proposal, to fund up to 10 of the largest cities in the U.S. to implement evidence-based programs using proven policy, environmental, and systems change strategies to address three public health priorities: tobacco prevention and control; obesity prevention and control (through improved nutrition and physical activity); and chronic disease detection and management.
$33.2 million for the Division of Adolescent and School Health's Coordinated School Health Program to increase capacity to improve child and adolescent health. With additional funding, CDC would fund 15 additional state education agencies, 25 additional local education agencies and one tribal government to implement CDC guidelines and tools to address tobacco use, obesity, nutrition and physical activity.
$52.77 million for the Healthy Communities Program, which invests in communities to identify and improve policies and environmental factors influencing health in order to reduce the burden of obesity and other chronic diseases. Additional funding would allow for expanded community investment for chronic disease prevention.
$90 million to expand CDC's Division of Nutrition, Physical Activity and Obesity to additional states. Currently only 25 states are funded. Grants allow state health departments to design, implement, evaluate and disseminate effective strategies relating to nutrition, physical activity, and obesity prevention and control.

Environmental Health:
Provide the resources necessary to measure our exposure to hazardous substances found in the environment, modernize and integrate health information sources to better track the health of Americans and help health officials prepare for and respond to the health effects of climate change. TFAH recommends:

$63 million for CDC's Environmental Health Laboratory's biomonitoring capacity to expand the assessment of the U.S. population's exposure to environmental chemicals in order to support policy decisions and enhance capabilities and capacity of state biomonitoring programs.
$50 million for the National Environmental Public Health Tracking Network to expand the program to link environmental and health data to identify problems and effective solutions that will reduce the burden of chronic disease.
$50 million for CDC's Climate Change Program to build climate change capacity in state and local health departments and fund applied climate change research.
$4 million for CDC's new Built Environment and Health Initiative, which would enable CDC to support the training and implementation of Health Impact Assessments.

Minority Health and Health Disparities:
Make progress towards eliminating racial and ethnic health disparities. REACH Across the U.S. (REACH U.S.) programs provide coordination and leadership for the advancement and translation of community-based participatory research into evidence-based practices, policies and community empowerment. TFAH supports a funding level of:

$60 million for REACH US.

Safe and Healthy Food:
Promote safe and healthy foods by bolstering funding for food safety and providing funding that will increase access to healthy foods.

$955 million in appropriations for FDA's food programs. New funding would support standards for safety, expand laboratory capacity, pilot track and trace technology, strengthen the import safety program, improve data collection and risk analysis and begin to establish an integrated national food safety system with strengthened inspection and response capacity.
$400 million for the Healthy Food Financing Initiative. The President's FY 2011 budget proposes this new initiative, which is designed to support local and regional efforts to increase access to healthy foods, particularly for the development of grocery stores and other healthy food retailers in urban and rural food deserts and other underserved areas. This multi-year, multi-agency initiative would involve the U.S. Department of Agriculture, the Department of Health and Human Services and the Department of the Treasury, other nonprofits, public agencies, and businesses with sound strategies for addressing the healthy food needs of communities.

Budget-Related Links

The President's FY 2011 Budget

The Department of Health and Human Services' FY 2011 Budget

The Centers for Disease Control and Prevention's FY 2011 Budget