The Bush administration's proposed fiscal year 2009 budget puts the health of millions of Americans at risk by failing to adequately invest in disease prevention and health promotion activities, the American Public Health Association (APHA) said.

"While balancing the budget is a critical goal, the administration's decision to drastically cut funding to crucial health agencies is short-sighted and fails to recognize the importance of investing in prevention," said Georges C. Benjamin, MD, FACP, FACEP (E), executive director of APHA. "Once again the administration has ignored the reality that cutting public health funding might save money in the short-term, but will lead to greater medical expenditures in the long-term as we must treat the illness we failed to prevent."

The president's budget proposes significant cuts in funding for the Centers for Disease Control and Prevention (CDC). Chief among the cuts is an elimination of the Preventative Health and Health Services Block Grant. Funded at a level of $97.3 million in fiscal year 2008, this critical funding enables states to fund essential public health activities as dictated by the unique needs of their communities. The proposal also includes a $135.5 million decrease in funding for CDC's Public Health Emergency Prepared (PHEP) state and local grant program, which helps ensure that state and local health departments possess the capacity to detect and respond to emerging public health threats.

"Each year that the CDC's funding is cut means another year in which our public health infrastructure is not keeping pace with the diseases and conditions that are responsible for the majority of death and disability in this nation, nor ensuring that our nation has the capacity to respond rapidly to emerging health issues," Benjamin said.

The president's budget also slashes funds to another critical public health agency, the Health Resources and Services Administration (HRSA). Bush proposes to eliminate funding for training doctors at children's hospitals and proposes to decrease funding for training nurses and other public health professionals by $240 million from fiscal year 2008 levels. Further hurting the nation's public health sector, the budget also calls for a $112 million decrease in HRSA funding for rural health programs, reducing funding to only $17 million.

Additionally, the proposed budget would cut federal Medicaid expenditures by $18.2 billion over five years and Medicare would be reduced by $556 billion over 10 years. These reductions would jeopardize the health of millions of lower-income and older Americans who rely on these programs to provide access to health care services.

While APHA opposes the many proposed budget cuts that will harm the health of our nation, the Association does applaud the administration's inclusion of a modest $129.7 million increase for the Food and Drug Administration (FDA) aimed at enhancing the government's efforts to ensure food and drug safety in the United States.

In response to the evolving public health challenges of the 21st century, our nation needs a federal budget that enables the public health sector to be able to respond to both the urgent public health threats that will emerge and the urgent realities we are facing today. APHA calls on Congress to take the health needs of our nation into consideration and to support the measures necessary to guarantee that all Americans have access to preventative health services that will improve the quality of their lives.

American Public Health Association