KHN

The U.S. public health system has been starved for decades and lacks the resources necessary to confront the worst health crisis in a century. An investigation by The Associated Press and KHN has found that since 2010, spending for state public health departments has dropped by 16% per capita and for local health departments by 18%. At least 38,000 public health jobs have disappeared, leaving a skeletal workforce for what was once viewed as one of the world’s top public health systems. That has left the nation unprepared to deal with a virus that has sickened at least 2.6 million people and killed more than 126,000.

To assess the state of the public health system in the United States, KHN and The Associated Press analyzed data on government spending and staffing at national, state and local levels. Here’s what data we used and how we did it.

KHN and The Associated Press sought to understand how decades of cuts to public health departments by federal, state and local governments has affected the system meant to protect the nation’s health. Here are six key takeaways from the KHN-AP investigation.

In an investigation last year, KHN detailed the rise and fall of Miami businessman Jorge A. Perez’s rural hospital empire, which spanned eight states and encompassed half of the rural hospital bankruptcies in 2019.

For Art Ballard, the local gym was like his second home. The 91-year-old former jeweler relied on his near-daily workouts to stay healthy and for social interaction. But when California instituted its stay-at-home order, Ballard’s physical health suffered. So did his mental health.

As health workers were dying of COVID-19, federal work-safety officials filed just one citation against an employer and rapidly closed complaints about protective gear.

The National Cancer Institute plans to launch a multisite study next year involving roughly 5,000 women to assess whether self-sampling at home for the human papillomavirus that causes cervical cancer is comparable to screening in a doctor’s office.

In a decision that surprised both sides of the polarized abortion debate, the Supreme Court struck down a Louisiana law that would require doctors who perform abortions to have admitting privileges at a nearby hospital. Alice Miranda Ollstein of Politico and Jennifer Haberkorn of the Los Angeles Times join KHN’s Julie Rovner to break down what happened, what comes next and how this case could provide a clue to the one challenging the constitutionality of the Affordable Care Act.

Chief Justice John Roberts joined the court’s liberals in the 5-4 decision that strikes down a state law requiring doctors performing abortions to have admitting privileges at nearby hospitals.

The use of the word “always” makes this claim a stretch.

While federal and state officials continue to wrangle over coronavirus testing, the population testing positive is skewing younger. Meanwhile, the Trump administration wins a round in court over its requirements for hospitals to publicly reveal their prices, and the fight over the fate of the Affordable Care Act heats up once again. Margot Sanger-Katz of The New York Times, Paige Winfield Cunningham of The Washington Post and Kimberly Leonard of Business Insider join KHN’s Julie Rovner to discuss this and more. Also, Rovner interviews former Obama administration health aide Dr. Ezekiel Emanuel, who has written a new book comparing international health systems.

Local governments around the country are declaring racism a public health crisis. That could be lip service, or it might lead to shifting resources from policing to health care, housing and other services, experts say.