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APHA policy brief examines impact of recession on Americans' health.

AS THE current economic recession worsens, the unprecedented demand for public health and safety net services will put increased pressure on an already-compromised system of safety net providers. With national health reform advancing, such work should be driven by investment in the public health infrastructure, according to a new APHA policy brief.

Released in March, "Surveying the Impact of the Current Economic Recession on the Health Care Safety Net" describes the deteriorating conditions of the nation's safety net and outlines the Association's recommendations in the face of pending national health reform that could affect how millions of Americans receive needed health care services. Public health infrastructure is the "backbone" of the safety net, said APHA Executive Director Georges Benjamin, MD, FACP, FACEP (E).

"The nation's disease prevention and health protection infrastructure took decades to build, but the economic recession threatens to tear it down at a time when preventable diseases such as obesity, diabetes, cancer, hypertension and heart disease are affecting millions of Americans and threatening to surpass all other spending," Benjamin said.

According to the policy brief, the health care safety net is a range of programs, professionals and institutions that either by mandate or by mission provide care to patients, regardless of their ability to pay for the services they receive. The "loosely connected patchwork" of safety net providers, the brief said, includes health departments, community health centers, clinics, primary care providers, nongovernmental organizations, emergency responders, urgent care centers and hospitals.

With its emphasis on population health, community-based services, environmental protections, access to care, disease prevention and surveillance, the public health infrastructure is responsible for much of the major gains in health status throughout the last century, said the brief. The document recommended that health reform include "substantive and strategic" investment in the public health and safety net infrastructure in tandem with plans to expand insurance coverage to all Americans.

"Our nation is at risk of losing those gains as the infrastructure begins to collapse under the weight of the economic recession," said Susan S. Abramson, MHS, director of APHA's Center for Public Health Policy and author of the brief. "The unprecedented demand for health care from poor and newly uninsured individuals has severely compromised the ability and capacity of safety net providers to provide health care now and in the future."

Among the factors contributing to the fragility of the health care safety net, according to the policy brief, are the growing shortage of trained primary care providers and a steady increase in the numbers of uninsured and underinsured patients along with an increase in the complexity and severity of their health conditions.

Efforts to protect the public's health must begin long before Americans fall ill and seek access to medical care, the brief said.

APHA provided copies of the policy brief to policy-makers on Capitol Hill as well as to APHA's affiliated state and regional public health associations.

For a copy of the brief, visit advocacy/reports/reports.

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Author:Johnson, Teddi Dineley
Publication:The Nation's Health
Date:Apr 1, 2009
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