The public health system we all count on is in trouble.

Every day we rely on public health to help keep our families safe and healthy; so do our businesses, schools and government agencies. Yet we take our local public health system for granted until there is a threat such as salmonella in peanut butter, E. coli in spinach or the death of a child from influenza.

In the early to mid-1900s, disease and death were more visible, especially among infants and young children. Contaminated food, air and water often made people sick. Polio, measles and small pox outbreaks were common, and workers were exposed to dangerous conditions. Since those times, public health has improved community health and safety. We now expect safe food and water. We expect to be protected from deadly diseases. Our life expectancy has risen by more than 20 years.

Declining funding over the past decade has weakened our public health system. In the perceived absence of the diseases of the past, we’ve reduced investment in the services that can prevent old threats from re-emerging and new threats from taking hold. We are not safe from diseases of the past. Rapid and frequent global travel has brought the threats of polio, measles and tuberculosis back to our community.

Last December, the Spokane Regional Health District investigated a potential polio exposure in newly arrived refugees. They had been staying in a refugee camp where a child was diagnosed with polio. Polio is a contagious disease that is preventable through a common childhood vaccine. However, one in four Spokane area 3-year-olds is not fully immunized and therefore is in danger of contracting a number of serious, preventable diseases, including polio. Thankfully, we found that the refugees had no signs of polio infection.

Like the polio scare, there are many close calls that the public does not see. Unfortunately, there are far too many real health threats, and they rarely make the news. Every day public health investigates new or potential cases of infectious disease. During 2006, we investigated and responded to 36 cases of whooping cough, 10 cases of infectious tuberculosis, 34 nursing home norovirus outbreaks, over a thousand cases of sexually transmitted diseases and hundreds of other health risks. But we are spread far too thin, and budget cuts have forced layoffs of two of our four disease investigators and many public health nurses. As a result, the health of our children, families and communities is at risk.

In Spokane and across the state, the negative impacts of the cuts in public health funding are already showing. Childhood immunization rates are dropping, the rate of sexually transmitted disease is rising and the need for service delivery to increasingly at-risk populations is growing. Without stable, long-term funding, local public health agencies will lack the resources to serve current needs and respond to emerging health threats.

Washington state ranks 44th out of 50 states in per-capita funding for public health protections. The Spokane Regional Health District receives less state funding today than it did 10 years ago; and when adjusted for inflation, funding has fallen behind by over $1 million a year. Each year that goes by leaves us less prepared for the next outbreak.

A solution has been proposed. A bipartisan legislative committee studied this issue for the past two years. It found that the public health system is deteriorating, and it unanimously recommended that $100 million from existing state funding be dedicated to public health. But the critical need for this funding is being overshadowed by issues that have a higher political profile. In this era of shrinking government funding, public health competes with other important government programs for a limited pot of resources.

We must all remember that public health protections come at a financial cost, but the payoffs are lifesaving. Investment in the protection and improvement of our community’s health must become a higher priority for our politicians and our citizens. The health of our communities is at stake.