The American Public Health Association (APHA) is pleased to announce the release of a timely issue brief entitled “Holes In the Net: Surveying the Impact of the Current Economic recession on the Health Care Safety Net.”

Written in response to the impact of the growing economic recession on the public health infrastructure, the brief examines how our nation’s health care safety net is unraveling at a time when millions of Americans have nowhere else to turn for health services. It also examines the marginalization of the public health infrastructure in its ability to strategically plan for and protect the public’s health.

“As the public health infrastructure struggles under the weight of the economic downturn, our nation is at risk of losing the major gains in life expectancy achieved throughout the last century,” said Georges C. Benjamin, MD, FACP, FACEP (E), executive director of APHA. “We must commit ourselves to ensuring that public health professionals around the nation are able to meet the needs of their communities.”

With anecdotes from around the nation, the issue brief explores how the economic recession of the past year has led to substantial cutbacks in the programs and personnel that are responsible for protecting the health of the American public. For example, health departments have reduced or eliminated community-based prevention services such as tobacco cessation, pregnancy prevention and childhood immunization programs, as well as clinical preventive services such as screening and early detection programs for cancer, diabetes and hypertension. Investments in the health care safety net for vulnerable populations are being dismantled, as is the public health infrastructure that supports disease prevention and health promotion programs.

Safety-net hospitals, too, are caught in the economic undertow. These hospitals “are essential to communities nationwide, especially during today’s economic crisis, which finds these hospitals treating higher volumes of uninsured and under-insured patients,” said Larry S. Gage, president of National Association of Public Hospitals and Health Systems.

“While stimulus dollars will certainly help stabilize the financial situation of many providers, this paper makes the case that temporarily shoring up the gaps in our health care safety net is not enough to repair a fragmented health system,” Benjamin said. “Rather, we must build a comprehensive and integrated health system capable of planning and executing population-based initiatives to prevent disease, promote wellness and assure accessibility to quality health care for all residents.”