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Impact of the 2008–2010 Economic Recession on Local Health Departments

Willard, Rachel MPH; Shah, Gulzar H. PhD, MStat, MSS; Leep, Carolyn MS, MPH; Ku, Leighton PhD, MPH

Journal of Public Health Management and Practice: March/April 2012 - Volume 18 - Issue 2 - p 106–114
doi: 10.1097/PHH.0b013e3182461cf2
Invited Article

We measured the impact of the 2008–2010 economic recession on local health departments (LHDs) across the United States. Between 2008 and 2010, we conducted 3 Web-based, cross-sectional surveys of a nationally representative sample of LHDs to assess cuts to budgets, workforce, and programs. By early 2010, more than half of the LHDs (53%) were experiencing cuts to their core funding. In excess of 23 000 LHDs jobs were lost in 2008–2009. All programmatic areas were affected by cuts, and more than half of the LHDs had to reduce or eliminate at least 1 programmatic area. The capacity of LHDs to provide core public health services was undermined by the economic recession.

This article describes the impact of the 2008–2010 economic recession on local health departments across the United States with the help of 3 Web-based, cross-sectional surveys.

National Association of County and City Health Officials (Ms Willard, Dr Shah, Ms Leep), and Center for Health Policy Research, George Washington University (Dr Ku), Washington, District of Columbia. Ms Willard is now with Department of Family & Community Medicine, University of California San Francisco, San Francisco, California. Dr Shah is now with the Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Georgia.

Correspondence: Rachel Willard, MPH, Center for Excellence in Primary Care, University of California San Francisco, 1001 Potrero Ave, Bldg 80 WD 83, San Francisco, CA 94110 (

This research was supported by award no. 5U38HM000449-02 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.

The authors declare no conflict of interest.

© 2012 Lippincott Williams & Wilkins, Inc.