The Impact of Chronic Underfunding on Americas Public Health System: Trends, Risks, and Recommendations - 2023

Decades of underfunding have left the nation's public health system ill-equipped to protect the health of Americans. The COVID-19 crisis illuminated weaknesses in the nation's public health infrastructure, including antiquated data systems, insufficient public health laboratory capacity, an under-resourced public health workforce, and the need for improved public health communications. These foundational public health capacities require increased, flexible, and sustained funding.The U.S. Centers for Disease Control and Prevention (CDC), the primary source of public health funding for state, local, tribal, and territorial health departments, is itself reliant on the annual federal appropriations process. Over the past two decades (FY 2014 – 2023), the CDC's budget has increased by just 6 percent after adjusting for inflation, leading to insufficient funding in key program areas such as emergency preparedness and chronic disease prevention.In addition to the risks associated with health emergencies, the country faces a growing number of people living with chronic diseases and the associated healthcare costs. While evidence-based public health programs that help prevent chronic disease are doing important work, insufficient funding has limited their accessibility and impact in many communities.TFAH is calling for annual funding for CDC of at least $11.581 billion in FY 2024, the level requested in the President's FY 24 budget (FY 2023 CDC funding is$9.2 billion).Other policy recommendations within the report include:Increase and sustain disease-agnostic funding to strengthen public health infrastructure. Public health experts estimate an annual shortfall of $4.5 billion in necessary funding for state and local health departments to provide comprehensive public health services in their communities.Strengthen public health emergency preparedness, including within the healthcare system. Investments should include the restoration of funding to the Public Health Emergency Preparedness Cooperative Agreement, the Healthcare Readiness and Recovery Program, and programs designed to support vaccine infrastructure as well as prevent, detect, and contain antimicrobial-resistant infections.Modernize the public health data system to ensure comprehensive and real-time data sharing during public health emergencies. Public health experts estimate that at least$7.84 billion is needed over the next five years for CDC's Data Modernization Initiative to strengthen public health data collection and reporting at the state and local levels. Congress should also provide sustained funding for CDC's new Center for Forecasting and Outbreak Analytics.Bolster the recruitment and retention of the public health workforce. In 2021, it was estimated that state and local public health departments needed to hire an additional 80,000 employees to be able to deliver a minimum set of public health services. The one-time nature of short-term emergency funding means that health departments will continue to experience understaffing.Address health disparities and the root causes of disease by addressing the social determinants of health and investing in chronic disease prevention.Invest in programs to prepare for and mitigate the impacts of climate change

Ready or Not 2022: Protecting the Publics Health from Diseases, Disasters and Bioterrorism

This report measures states' degree of preparedness to respond to a wide spectrum of health emergencies and to provide ongoing public health services, including disease surveillance, seasonal flu vaccination, safe water, and expanded healthcare services during emergencies. It includes policy recommendations for strengthening the nation's health security

Assessing Child-safe Culture and Practices in Organisational Settings: a Validation and Refinement of Kaufman\u27s Organisational Safety Climate Survey

Using an Australian sample of employees (n = 1068) we assessed the psychometric properties of Kaufman’s Organisational Safety Climate Survey and its practical utility for measuring child-safe culture within organisations. The 60-item survey was found to have adequate psychometric properties. Initial factor analyses indicated a unidimensional factor structure, despite the survey being originally conceptualised into four subscales. Cronbach’s α coefficients were .95 for the full survey, with subscales ranging from .65–.94. However, qualitative feedback from respondents indicated that the survey was somewhat laborious and repetitive, with some item ambiguity noted. Refinements to the survey resulted in a 24-item short-form survey. The psychometric properties of the short-form survey were re-assessed. Factor analyses indicated a three-factor solution. Despite a significant reduction in items, internal consistency of the scale was not compromised; reliability of subscales also improved. Validation of this short-form survey as an alternative, time-efficient measure to maximise employee participation and contribution, is recommended