Shutting Down Public Health

How putting the government on hold could affect our health

Published on October 3, 2013 by Kathleen Bachynski

While Americans decry the National Zoo’s lacking “Panda Cam” coverage and fall travelers find the gates to Yosemite and other national parks closed to visitors, the collateral damage from the U.S. government shutdown continues to create alarming voids in many government programs. Public health services have been particularly hard hit. Until the U.S. Congress passes a new budget, key elements of the American public health system remain in limbo.

As The Guardian reported, “The Centers for Disease Control and Prevention are facing a reduced ability to detect and investigate disease outbreaks. The annual influenza program—the one that tracks the flu and helps people get flu shots—has been shut down. The CDC has also stopped offering its usual assistance to state and local authorities, who rely on the agency for help in tracking unusual outbreaks.”

To mirror my own words to Ta-Nehisi Coates of The Atlantic, this means the flu program has been shut down at a disconcerting time—right as flu season begins. Now, we just have to hope there are no unusual outbreaks of disease, since we won’t be able to adequately track or respond to them. This is quite a serious risk for a nation of over 300 million people to take, even if just for a few days.

The public health impacts of the shutdown go even beyond the CDC. The FDA is currently unable to support most of its routine food safety inspections. The EPA’s monitoring of air and water quality has been disrupted. Cancelled blood drives at federal agencies have threatened the blood supply in some areas.

Some of the nation’s most vulnerable citizens will be most deeply affected. The shutdown’s impact on the National Institutes of Health will prevent children with cancer from being able to enroll in clinical trials. In addition, the government has stopped funding the Special Supplemental Nutrition Program for Women, Infants and Children, also known as WIC. This places nine million low income mothers and infants at risk for even less stable access to regular, nutritious food.

How is it possible that we are able to run these risks? James Fallows of The Atlantic notes that:

“As a matter of substance, constant-shutdown, permanent-emergency governance is so destructive that no other serious country engages in or could tolerate it. The United States can afford it only because we are—still—so rich, with so much margin for waste and error.”

However, some of the consequences of the shutdown, such as our inability to adequately monitor infectious disease, have no respect for wealth. Viruses are not deterred by dollars. E. Coli can still contaminate food. This shutdown represents a roll of the dice that everything will be fine despite an absence of adequate public health surveillance and response. The CDC has furloughed 68 percent of its people both in the United States and globally. That’s a dangerous gamble to make in a globalized world where diseases can cross the planet in under a day.

So perhaps all we can do is maintain a safe distance from each other until our national public health agencies are back up to full strength. Wave hello to your friends instead of shaking hands. Don’t hold onto the pole on the subway. If you have a newborn baby who is especially vulnerable, you may want to be especially careful before leaving your house.

I do not mean to be unduly alarmist. Most likely, nothing will happen. But, the public health services that are currently locked out are the ones that work to make sure nothing does happen. Public health, when at its best, maintains the health of our country and world without the public actually realizing it. Often the most vital programs are only known in their absence.

Even though they are often invisible, these public health services are essential to the health and well-being of all Americans. We can only hope this shutdown does not give us a chance to find out the hard way just how essential they are.

Edited by Joshua Brooks

Kathleen Bachynski
Kathleen is a Ph.D. candidate in the Department of Sociomedical Sciences at Columbia's Mailman School of Public Health, studying the history and ethics of public health with a focus on injury prevention. She is also researching evidence-based policies related to HPV vaccination and childhood obesity prevention. Kathleen holds an M.P.H. in epidemiology with an interdepartmental concentration in genetics from the University of Michigan.

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Thank you so much Patches. Indeed, here’s hoping the shutdown will end soon and our public health services can get back up to full strength.

Very timely and on point article. Nationally, a roll of the dice- let’s hope we’re lucky.

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