Local and state health departments across the U.S. monitor communities for infectious disease outbreaks, ensure that restaurant food is safe, and provide walk-in immunization and clinics for sexually transmitted diseases. Yet since the financial crisis began in 2007, 40 percent of the nation's health departments have suffered serious budget cuts that have forced them to shed a quarter of their workforce. Many experts fear that these cutbacks are putting the country at risk for epidemics.

Consider Duval County, Florida: it is in the midst of the worst tuberculosis outbreak in the U.S. in 20 years, yet in March, Florida governor Rick Scott signed a bill downsizing the state health department and closing A. G. Holley State Hospital, which specialized in treating tuberculosis patients who were not taking their medications, a practice that spurs drug resistance. (Mike Haridopolos, president of the Florida Senate, has said that the budget helped make the state “more attractive to business owners and entrepreneurs,” in part because it did not raise taxes.) “The outbreak is among the very people who were typically candidates for A. G. Holley,” says Marc Yacht, former president of the Florida Public Health Association. Some patients were transferred to other hospitals, and the four who were discharged are considered noninfectious, and health workers are checking on them daily, reports the Florida Department of Public Health.

This article was originally published with the title A Shot in the Arm.

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