County health departments could be less prepared to respond to disease outbreaks or bioterrorism attacks because of state and federal budget cuts, according to a new report from the Washington-based Trust for America’s Health and the Princeton, N.J.-based Robert Wood Johnson Foundation. The report, “Ready or Not? Protecting the Public from Diseases, and Bioterrorism,”found that recent and proposed budget cuts threaten health departments’ capacity to respond to health emergencies like the H1N1 flu pandemic of 2009.

Health departments’ funding has suffered as the economy weakened, affecting staffing and supply levels. “Some of the most elementary capabilities, including the ability to identify and contain outbreaks, provide vaccines and medications during emergencies, and treat people during mass traumas are experiencing cuts in every state across the country,” Jeff Levi, executive director of the Trust for America’s Health, said in the report.

Bay County, Mich.’s health department has seen a 10 percent decrease in its budget since 2010 with more cuts expected this fiscal year, according to the Washington-based National Association of Counties (NACo). In Los Angeles County, federal Centers for Disease Control (CDC) public health preparedness funding dropped about $2 million last year. “After years of progress following the Sept. 11 and anthrax attacks of more than 10 years ago, health departments are losing ground,” NACo says.

The report said cuts this year and expected cuts next year could threaten several local health departments, including 51 of 72 cities in the Cities Readiness Initiative that supports the ability to rapidly distribute and administer vaccines and medications during emergencies. Also at risk are all 10 state “Level 1” labs that can test for chemical terrorism and accidents. Twenty-four states risk losing CDC support to respond to health emergencies, the report said.

"We're seeing a decade's worth of progress eroding in front of our eyes,” Levi said.

To view state-specific information and download the full report, visit the Trust for America’s Health website.