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first_imgMar 10, 2009 (CIDRAP News) – US public health spending is very uneven from state to state and is eroding in the face of the economic recession, the nonprofit group Trust for America’s Health (TFAH) said in a report released today.State shares of Centers for Disease Control and Prevention (CDC) funds for disease prevention and other public health purposes averaged $17.60 per person in fiscal year 2008, but they ranged all the way from $12.74 for Indiana to $52.78 for Alaska, says the report by the nonpartisan health advocacy group based in Washington, DC.Meanwhile, state and local public health departments shed 11,000 jobs in 2008, said Robert (Bobby) Pestronk, executive director of the National Association of County and City Health Officials (NACCHO), at a press teleconference on the report today.”A survey by NACCHO and CSTE [the Council of State and Territorial Epidemiologists] found that another 10,000 public health jobs may be cut in the next year or two,” Pestronk added.Jeff Levi, executive director of TFAH, said overall public health spending, now about $35 billion a year, is about $20 billion short of what is needed.The report, titled “Shortchanging America’s Health: A State-by-State Look at How Federal Public Health Dollars Are Spent and Key State Health Facts,” was produced in cooperation with the Robert Wood Johnson Foundation.Uneven state sharesLevi said about 75% of the CDC’s budget is distributed to states and communities. For fiscal year 2008, those allocations totaled $5.35 billion, according to the report.”It’s a tiny fraction of what we spend on treating people after they become sick,” Levi said. “Our priorities are upside down.”By region, the Northeast and West received higher shares than the Midwest and South. State per capita amounts averaged $22.49 in the Northeast, $23.94 n the West, $18.43 in the South, and $17.69 in the Midwest.Levi said that for some programs the CDC just doesn’t have enough money to fund every state. “In most cases where states are on the lower end of the scale, it’s because there’s not enough funding to go around and it’s often up to the luck of the draw.” For example, he said only 22 states are funded for school health programs.Because the CDC has limited funds to distribute, it awards some money on the basis of a formula and the rest on a competitive basis, with the result that some states lose out, Jim Pearsol, chief program officer for public health performance at the Association of State and Territorial Health Officials (ASTHO), told CIDRAP News in an interview.The TFAH report shows that state shares of federal health funding streams other than from the CDC also varied considerably. Funds from the Health Resources and Services Administration (HRSA) ranged from $9.96 for Kansas to $70.75 for Alaska, averaging $21.43 per person overall. The national total for 2008 was about $5.72 billion.Allocations for hospital preparedness for public health emergencies averaged $1.43 per person but varied from 72 cents for New York to $2.15 for Wyoming, the report says. The money is distributed by the Office of the Assistant Secretary for Preparedness and Response (ASPR) in the Department of Health and Human Services. The total that went to states in 2008 was $361.6 million.The report also looks at state public health funding and shows wide disparities. It lists median state spending on public health at $33.71 per person, with a range all the way from $3.37 in Nevada to $172.21 in Hawaii. It notes that states allocate and report their budget in different ways and provide varying levels of detail, making comparisons difficult.Health budget cutsThe report says that at least 46 states are facing deficits in their 2009 and/or 2010 budgets.Pestronk said the state and local public health job losses last year and additional expected ones will have noticeable effects: “In the face of the Salmonella outbreak, restaurants won’t be inspected as frequently as they had been.” In addition, surveillance of infectious diseases will be reduced, and officials will sometimes have to decide between immunization and treatment programs, he said.A national survey of 2,422 local health departments in November and December found that more than half had either laid off employees or lost some through attrition, according to the report. It says that 44% of state health departments have a job vacancy rate of 10% or higher.Levi noted that the recently passed economic stimulus bill included $1 billion for public health. He said that includes $650 million for community disease prevention, $300 million to expand immunization programs, and $50 million to battle healthcare-associated infections.”We still don’t know the exact nature of the initiatives the administration will plug these funds into,” he said. The money will make a big difference, he said, adding, “It’s a critical investment but a one-time-only investment.”Pestronk said it appears that the immunization funds may be used mainly to buy vaccines, but NACCHO hopes the money can also be used to hire staff. “With the kinds of layoffs and cuts we’ve been talking about, the very staff needed to deliver the vaccines are being lost at the same time that funds are being made available to increase the supply,” he said.An analysis by TFAH and the New York Academy of Medicine concluded it would take a total of $55 billion to $60 billion a year, or $187 per person, to adequately fund public health, the report states. Levi said current spending totals about $35 billion.”Based on the current funding model, the federal government should provide 60 percent of this increase ($12 billion more than fiscal year 2005 dollars) and state and local governments should provide 40 percent of this increase ($8 billion annually),” the report says.It acknowledges that states and localities will find it tough to increase funding during the current recession, but suggests that they devise funding strategies to implement once the economy improves. Possible sources of new money include taxes on soda, candy, and tobacco products, it says.State officials’ viewsDavid Sundwall, MD, executive director of the Utah Department of Health, said he welcomed the essential message of the report but attached less importance to the state funding rankings. The report lists Utah as 39th in its share of CDC funding, at $15.73 per person.”Those of us who are state health officials are grateful that there are people looking at this because we’re convinced that public health in general is underfunded,” he told CIDRAP News. “In my view as state health officer, I wouldn’t consider the rankings as useful to me as the message. I’m not going to lose any sleep over the ranking but will use my voice to call for better funding for pubic health, as opposed to medical care and research.”At $2 trillion a year, US healthcare spending has gotten out of balance with the rest of the economy, Sundwall said, adding, “We’ve got to look at what we’re investing in the healthcare complex and get back into things that improve our health, and not just provide services.”Sundwall said he questions the utility of state rankings for health spending. He observed that in evaluations by the United Health Foundation, Utah consistently ranks high for general health indicators, but the state gets “dinged” for relatively low per capita spending on public health.”While I would welcome more money and we’d spend it wisely and well, I’m not sure it’s a fair indicator,” he said. “If I were a legislator and I saw our health rankings and some of the success we do enjoy, I’d probably put it into other competing causes.”Sundwall said public health in Utah is feeling the effects of the recession and resulting budget cuts, even though the economy there is better than in many other places.Last September the Utah Legislature cut $33 million out of the health department’s budget, and the new budget the legislature is working on now would take about another $40 million, he said. “That requires me to lay off people. . . . It’s a sad, hard time to be a manager and have to go through these retrenchments. But we also acknowledge that in this economy, the public sector has to carry some freight just like the private sector.”Craig Acomb, chief financial officer at the Minnesota Department of Health, raised questions about how fully the TFAH report reflects Minnesota’s spending on public health and its share of federal health dollars. The state ranks 40th in CDC funds received, 48th in HRSA funds, and 28th in ASPR funds.While acknowledging that he hadn’t studied the report, he said it probably does not reflect a statewide health improvement program, passed this year, that will provide $47 million over the next 2 years to battle obesity and tobacco use.Also, he said, “A lot of public health in this state is funded at the local level,” with 53 community health boards across the state drawing funds from property taxes. Further, he said the state receives other federal funds for public health purposes not covered in the report, such as Environmental Protection Agency money to protect drinking water.”Even though we may not get the most money from the CDC, we have some of the highest health indicators in our people, with some of the lowest rates of diabetes, infant mortality, obesity,” Acomb said. “We’re certainly making effective use of the resources that we have.”Pearsol, of ASTHO, said he thinks the report “resonates well with what the states are experiencing.” He commented that the wide variation in CDC allocations to states shows that the CDC itself is underfunded, and added, “It’s quite true that the recession is having a devastating impact on general revenue funds in states. . . . Those [public health] job losses are real losses.””The whole point that TFAH is making is that doubling the investment would be more akin to the need from a population-based health perspective,” he said.See also: Mar 10 TFAH news release with link to the full reporthttp://healthyamericans.org/report/61/shortchanging09last_img read more

first_imgForeign Minister Retno Marsudi has expressed condolences over the passing of an Indonesian Military (TNI) soldier with the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (DRC), or MONUSCO, who died during an attack against the peacekeeping mission.“My deepest condolences on the passing of Sgt. Maj. Rama Wahyudi, an Indonesian peacekeeper with the MONUSCO mission in the DRC,” Retno said in her Twitter post on Tuesday.Duka cita yang mendalam atas berpulangnya Serma Rama Wahyudi, salah satu anggota pasukan perdamaian Indonesia yang bertugas di Misi MONUSCO, Kongo (23/06).— Menteri Luar Negeri Republik Indonesia (@Menlu_RI) June 23, 2020Foreign Ministry Multilateral Affairs Director General Febrian Ruddyard said Rama Wahyudi had died from a gunshot wound. Citing a report from MONUSCO, the ministry said another Indonesian soldier, First Pvt. M. Syafii Makbul, was also injured during the assault and was currently under intensive medical treatment.The attack, which according to the UN peacekeeping mission was carried out by “suspected members” of the Allied Democratic Forces (ADF) — an armed group in eastern DRC — took place late Monday around 20 kilometers from the city of Beni in the country’s North Kivu province, AFP reported.Retno said the UN Security Council lambasted the attack against MONUSCO and asked the DRC authority to investigate the attack and take the culprit to court.She offered her highest appreciation to the late soldier and sent her thoughts and prayers to his grieving family.”Highest appreciation to Sgt. Maj. Rama Wahyudi for his service and sacrifice in maintaining world peace. May God give fortitude to his family,” said Retno. (aly)Topics :last_img read more

first_imgAfter losing multiple starters and coaches in the offseason, it was understandable to expect the Badgers to go through the typical bumps and bruises associated with breaking in a new team during the nonconference part of its schedule.But after just two games, it’s fair to say nobody expected this.Wisconsin has built an identity on offense in recent history – a heavy dose of the run, controlling the clock and lethal play-action passes. However, the team offense that played against Oregon State hardly resembled a Wisconsin team in recent memory. There was barely a push on the offensive line throughout the game with plenty of three-and-outs and enough missed opportunities to make even the most hardened Badger fan cringe.To put it lightly, the offense looked dead Saturday. The unit failed to find its rhythm on the field until the waning minutes of the game, and the offensive line offered O’Brien less than adequate protection against a majority of the Beavers’ blitzes. Out of the Badgers’ 13 offensive drives, only two went for more than seven plays, with the longest drive lasting just three and a half minutes.Even more startling was the complete lack of a dominant run game. For the second week in a row, Monte? Ball found nowhere to rush, as the run game yielded Ball just 61 yards on 15 carries and 35 total team rushing yards – an uncharacteristic group of numbers for a program that prides itself on dominance in the offensive trenches.Going into this season, there were question marks on the offensive line. Although they had depth, the Badgers still had to replace three starters, two of which started in multiple Rose Bowls. However, the overall performance of the group in this young season is far from acceptable. After these lackluster offensive numbers, it shouldn’t come as a surprise if Wisconsin head coach Bret Bielema decides to shake things up even further after the departure of former offensive line coach Mike Markuson and start some new faces next to Ricky Wagner and Travis Frederick. In a long season of physical football, the Badgers will only go as far as their rushing game and the play of their offensive front, something that must improve rapidly over the next two games before the start of the conference season.The play-calling itself has also been less than stellar in the first two games. It almost seems as if Wisconsin isn’t running a pro-style offense anymore (out of the Badgers 61 total plays Saturday, 38 were passes), and short, one-to-three yard pass plays have dominated the Badgers’ aerial attack. In the past two games, you could count on just one hand how many times the Badgers tried to throw the ball even moderately deep. Besides the deep bomb to Jared Abbrederis against Northern Iowa, the Badgers and Canada have yet to test O’Brien’s arm.One thing Canada should begin to consider is the use of a screen game. With the way Oregon State was able to reach O’Brien, a basic dump-down screen to Ball would be a perfect neutralizer for an overeager blitzing defense. And it’s also a good way to get O’Brien into a comfort zone. While Wisconsin passed more times than it ran the ball Saturday, it was sadly a necessary evil. Additionally, the Badgers may need to consider passing on first and second down more than half the time, as the running game has not been able to yield those first downs of which the Badgers have been in such dire need. And don’t give up on O’Brien just yet. Besides an ill-advised throw off his back foot that led to an interception and a costly fumble, the Badgers’ junior quarterback had to respond to constant pressure and a collapsing pocket for most of Saturday’s game. Given adequate time, O’Brien has shown the ability to make timely throws, and his efficiency will increase as his offensive line improves.Also keep in mind that the Badgers have yet to prepare for an opponent with film from this current year. With Northern Iowa being the season-opener and Oregon State’s first game of the year coming against Wisconsin, it will be interesting to see how much of a difference up-to-date film study will make in game-planning and preparation.Looking to the immediate future, a very formidable Utah State team coming off its first win over Utah in 15 years will pose another challenge to the Badgers this weekend. If the Badgers hope to turn this season around, there will be some considerable soul-searching to perform in practice this week. In just a few short weeks, the Badgers will have to mosey on to Lincoln, Neb., to face the Cornhuskers at Memorial Stadium against a Nebraska team hungry to avenge its humiliating 48-17 rout last year in Camp Randall.While there are plenty of other less-than-desirable aspects to the Badgers’ performances as of late – mainly the absence of an adequate pass rush on defense – much has changed after the loss. This team can no longer finish undefeated or compete for the national championship game. That’s it.The Big Ten Championship Game and the Rose Bowl still remain realistic goals, even though the road to get there remains much more treacherous than before.Nick is a fifth-year senior majoring in history and English. Love/hate the column? Email him at nkorger@badgerherald.com or tweet at him @nickkorger and let him know what you think of the Badgers’ struggles so far.last_img read more