OXFORD, N.C. -- North Carolina has spent fewer and fewer dollars on public health over the past decade, and local health officials say inconsistent funding has led to reduced staff and resources, which likely worsened the fallout from the pandemic.

Data from Kaiser Health News show spending for the state's 85 local health departments dipped by more than 27% between 2010 and 2018.

Lisa Macon Harrison, vice president for the National Association of County and City Health Officials and health director for Granville-Vance Public Health, said most departments rely on a patchwork of disease-specific grant funding and federal dollars from the Centers for Disease Control and Prevention.

"There's also not a full appreciation of the mandated services and restrictions our system asks of us, and the lack of flexibility," Harrison pointed out. "We have to sometimes be able to pivot and be as nimble as we'd like to be in situations like we're in now, where we are managing change every single week."

According to research by Trust for America's Health, public health represented just 2.5% of all U.S. health spending in 2017.

The report also found, nationwide, public-health surveillance infrastructure for detecting infectious diseases and environmental threats hasn't kept up with current technologies and are in dire need of upgrades.

Meanwhile, the state's population grew to an estimated 10.5 million people as of July 1, 2019, the fourth year in a row North Carolina has grown by more than 100,000 people, according to the latest data from the U.S. Census.

Jason Baisden, senior program officer for the Kate B. Reynolds Charitable Trust, said policymakers should view public health as a critical part of the state's healthcare safety-net infrastructure.

"Investments today in our public health infrastructure and things like housing have dividends for improved health," Baisden asserted. "And we believe, lower cost, in the long-term, and it's a discussion that North Carolina and North Carolinians need to have."

Harrison noted she's grateful more residents are becoming aware of the services their local health departments provide as COVID-19 vaccinations ramp up, but she argued communities need long-term, sustainable solutions.

"But it also calls our policymakers to action to make sure that we are able to not only survive as an infrastructure through this pandemic response and vaccination program, but that we thrive enough to prevent it from happening again," Harrison contended.

She pointed out in addition to meeting residents' basic health needs and providing immunizations, public-health departments work to prevent the start and spread of outbreaks, monitor food safety in restaurants and other public places, keep drinking water clean, and respond to natural disasters and emergencies.

ARLINGTON, Va. -- COVID-19 has exposed inequities in health care, and this year's Greater Washington Region Heart Walk aims to raise funds to close that gap and lead folks to healthier lives.

Cynthia Cifuentes, chair of this year's Heart Challenge, said she was compelled to get involved after watching her father struggle with cardiac problems without health insurance while growing up. At age nine, she witnessed his first heart attack, which had a major impact on her life; a health struggle she said the Walk aims to alleviate by supporting research and encouraging healthier lifestyles.

"Most importantly, I think knowing and understanding now how he could have taken steps early on to prevent some of his health-care outcomes later in life," Cifuentes explained. "A lot of that comes with just access to healthy foods, walking in the park, and so forth."

She pointed out the long-term impact of the coronavirus will continue to affect cardiovascular health. To stay safe, this year's walk on Nov. 6, hosted by the American Heart Association, is being held both online and in person on the National Mall. Go to GreaterWashingtonHeartWalk.org to get involved.

Cifuentes' father survived, but she thinks he did not fully recover from his heart attack and has been on medications ever since. She said the pandemic raised fears for his safety, along with many other Americans with heart disease, which made this year's walk especially critical, after a year-and-a-half of pandemic worry and isolation.

"This is a moment in time where it gives us the time to just come out from our chairs, our offices, our homes," Cifuentes urged. "You can even do it in your home and get moving. And part of mental health is also your physical health, and how for your total well-being, movement is a critical part of that."

A Journal of the American Medical Association study showed 78% of patients who recovered from COVID-19 at home within the previous two to three months had abnormalities in their hearts, and 60% had ongoing heart inflammation.

COLUMBUS, Ohio - Congress has an opportunity to help lower prescription-drug costs for Ohioans, who, along with other Americans pay roughly three times as much for the same medications as people in other countries.

The average annual cost of prescription drugs increased 26% between 2015 and 2019, while the average income for Ohioans rose only 14%.

Mindi Patterson of Dayton says her 48-year-old sister-in-law paid more than $800 a month for insulin to manage her Type 1 diabetes. After losing her job and health insurance in December 2018, she turned to an over-the-counter insulin.

"She purchased that as a last-ditch effort to make it to the 26th when she got her last paycheck where she would be able to afford her medication," said Patterson. "On Christmas morning, she passed away. She went into diabetic ketoacidosis from rationing her insulin."

The budget reconciliation package being debated in Congress would allow the federal government to negotiate prescription-drug prices for people on Medicare and private insurance.

Drug companies argue it would hamper the development of new medications. But polling found that most Americans believe pharmaceutical companies still would make enough money to invest in research even if prices were lower.

Cincinnati-area state Rep. Brigid Kelly - D-31st - said there is broad support for federal action to address rising prescription-drug prices.

"More than nine in 10 Americans support giving Medicare the power to negotiate for lower drug prices," said Kelly. "That means it's supported by Democrats, that means it's supported by Independents, that means it's supported by Republicans; that means it's supported by people in urban areas, rural areas, men, women."

Meanwhile, lowering drug prices continues to be a pressing issue for Patterson, whose two sons and her husbands have Type 1 diabetes. With her husband on permanent disability, she said the family struggles to afford insulin.

"We have actually dug through trash to pull out previous diabetic supplies we've used to re-use them," said Patterson. "We have asked other people in the community for help getting supplies. When your medication is life or death, you try to figure it out to the best of our ability. "

About eight in ten U.S. adults recently polled said the cost of prescription drugs is unreasonable.

SEATTLE - A proposal to repeal King County's law requiring helmets while riding bicycles has health professionals concerned.

The King County Board of Health is considering removing the 2003 law because of its disproportionate enforcement on people of color.

But doctors and health organizations such as the Brain Injury Alliance of Washington are worried the repeal could lead to an uptick in people not wearing helmets and getting hurt - possibly permanently.

Deborah Crawley, executive director of the organization, said board members did not reach out to her or other health professionals on this issue.

"Brain injuries are one of the most devastating effects from injuries sustained from bicycle injuries," said Crawley. "Helmets being utilized, for the majority reason, to prevent brain injuries. That's why helmet laws were instituted."

The King County Board of Health was scheduled to take a vote on repeal last week. But after an extensive public hearing, members decided to postpone their vote.

The repeal would affect Seattle and much of King County, although 17 cities in the county have their own helmet laws in place.

Richard Adler is a Seattle attorney who represents people with traumatic injuries, especially brain injuries. He said he agrees that it's wrong the law is being enforced in a racially discriminatory ways.

"I get that," said Adler. "I support that. I'm with you on that, but you can achieve that in a different way than just repealing a mandate because we know that education alone does not work."

Adler said it's important to understand how precious our brain is.

"You can get a new hip, you can get a new knee, you can get a new shoulder, you can get a new elbow, you can get a new wrist, you can get a new ankle," said Adler. "You can't get a new brain. You only get one."

The King County Board of Health is expected to meet again in November to vote on this issue.




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