Public health in action (photo: Michael Appleton/Mayoral Photography Office)
One undeniable lesson of the COVID-19 pandemic is that those who shortchange public health put us all at risk. And if there were ever a time to appreciate the value of public health, it is now. Our local health infrastructure in New York City — which has experienced years of federal and state disinvestment — has been tested as never before. Every ounce of its capacity has been activated and we’ve felt every dime it’s been shortchanged.
That is why we looked at the first draft of Governor Cuomo’s executive budget in disbelief. The budget presented in January included a $50 million annual cut to public health funding in New York City.
Thankfully, the State Senate and Assembly rejected these devastating cuts in their budget proposals. And the governor recently announced $5 billion in additional revenue that could prevent these cuts — and others — from happening when the new state budget is enacted by the April 1 start to the new state fiscal year.
However, the proposal reflects how some leaders continue to take public health for granted.
Public health is not an ‘event’ that begins and ends with an emergency. It is a daily practice of identifying and addressing the issues that cause preventable suffering. The pandemic’s disproportionate impacts reflected society’s biases and how the health needs of Black and brown communities had too often been overlooked by government.
Further cuts are not just myopic, but also immoral.
Cuts to public health take sorely needed dollars from Early Intervention programs that serve children with developmental delays. They hit Nurse Family Partnerships that support healthy pregnancies and babies through one-on-one support. Sexual health clinics, tuberculosis detection and treatment, and much more rely on vital funding to survive. Beyond these services, mental health, substance use, and developmental disability providers have all suffered cuts in the past and could again.
All of these services are public health in action.
In the best of times they have a lifesaving impact. During COVID-19, many have been put in the service of the emergency response. Sexual health clinics repurposed testing machines to run covid tests. Mental health hotlines admirably handled a surge in calls as stressed, grieving, and anxious New Yorkers turned to them for comfort. Nurses volunteered their services at vaccine hubs and children’s services rapidly moved to virtual programming.
Now is the time for massive investment in public health. We cannot let history repeat itself; New York City’s economic recovery and the health of our communities depend on this budget. If we don’t commit to investing in public health now, the cost down the road will be far greater.
Dr. Dave Chokshi is New York City’s Health Commissioner. On Twitter @NYCHealthCommr.