What happens to local public health as federal funding vanishes?
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What happens to local public health as federal funding vanishes?
Chrissie Juliano is the executive director of the Big Cities Health Coalition. 80% of the CDC’s domestic budget goes to community-based organizations, universities, and state and local communities. Cuts to public health hobble the system that is meant to prevent death and disease, Juliano said. Juliano urged journalists to take time in the coming months to document the impact that cuts will have on communities. The impact of budget cuts will vary throughout the country depending on how reliant each system is on federal funding, she said. She emphasized the importance of showing both the successes and failures of the system to hold officials accountable.
As federal funding disappears, what happens to public health at the local level? Chrissie Juliano, MPP, executive director, Big Cities Health Coalition
By Gladys B. Vargas, California Health Journalism Fellow
The Trump administration’s drastic cuts to the Department of Health and Human Services are having immediate negative effects on communities across the country, according to Chrissie Juliano, executive director of the Big Cities Health Coalition.
During her lightning talk at Health Journalism 2025 in May, Juliano stated that 80% of the CDC’s domestic budget goes to community-based organizations, universities, and state and local communities.
“ Cuts to public health hobble the system that is meant to prevent death and disease,” Juliano said. “Prevention is the key to public health. When we tear down these systems, we are already starting behind.”
Governmental public health agencies play a role that health care providers or regular community members cannot, Juliano said. For example, doctors cannot mandate a minimum age restriction on tobacco products. She also reiterated that public health agencies focus on prevention, while health care is for the most part reactive.
Juliano described governmental public health as “a patchwork quilt” of federal, state, territorial, tribal and local governments. She urged journalists to take time in the coming months to document the impact that cuts will have on communities.
Photo by Zachary Linhares
One such example Juliano gave was the measles outbreak in Texas. Dallas County Health used COVID funding to set up 50 vaccine clinics that targeted the schools with the lowest vaccination rates when measles became a concern. But when the Trump administration cut COVID funding on the assertion that the pandemic is over, those vaccine clinics had to be canceled.
To illustrate the importance of federal subject matter expertise that will be lost due to budget slashing, Juliano gave an example from Milwaukee, Wis., where a child was found to have absurdly high lead levels in their blood. Upon investigation, health officials learned the student had been eating chips of paint from their school. Concerned about other schools having the same issue, the health commissioner reached out to the CDC to request additional staffing and expertise. Juliano emphasized that the amount of expertise that is available at the federal level for cases such as this will no longer be accessible to state or local governments.
Juliano urged journalists to track stories like these closely at the local level, since the impact of budget cuts will vary throughout the country depending on how reliant each system is on federal funding. She also emphasized the importance of showing both the successes and failures of the system to hold officials accountable.
“I think most public servants know that that’s part of the job, and would love to tell their story,” Juliano said.
Gladys Vargas is a 2023-2025 fellow with UC Berkeley and The OC Register.