51: New York Times PH Survey

Danielle Ivory, a journalist for the New York Times, explains the results of the newspaper’s survey of hundreds of local public health departments; Senate budgeteers release FY 22 Appropriations bills, including a historic increase in funding for...

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Danielle Ivory, a journalist for the New York Times, explains the results of the newspaper’s survey of hundreds of local public health departments; Senate budgeteers release FY 22 Appropriations bills, including a historic increase in funding for the CDC; Ramya Dronamraju, a Senior Analyst on ASTHO’s Maternal and Infant Health team, discusses ASTHO member policy responses to intimate partner violence and substance use disorders; and we follow the CDC’s Advisory Committee on Immunization Practices as it meets to consider the Moderna and Johnson and Johnson COVID boosters.

New York Times: Why Public Health Faces a Crisis Across the U.S.

ASTHO Legislative Alert

ASTHO Blog Article: States Explore the Relationship Between Partner Violence and Substance Use Disorders

CDC Webpage: Advisory Committee on Immunization Practices

Webpage: The Great ShakeOut

ASTHO logo



This is Public Health Review Morning Edition for Thursday, October 21st, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.

Since the start of the COVID-19 pandemic, lawmakers in several states have passed more than 100 new laws limiting public health authority. In the last 18 months, public health departments have lost scores of employees due to fatigue and burnout. Across the nation, those trying to protect their communities from a deadly virus have received death threats from people angry about masks, vaccines, and other restrictions.

The New York Times recently polled health departments to find out how they're doing. It reported the results of those surveys this week.

Journalists Danielle Ivory and colleague Mike Baker wrote the story. They were supported by a team of Time staffers gathering and crunching data. Ivory tells us about the project in today's morning conversation.


My name is Danielle Ivory, I'm a reporter at the New York Times, and, since the beginning of the pandemic, I've been helping to lead a team of journalists that collect and thoroughly vet coronavirus data and vaccination data across the country. It's a very ambitious effort that the Times has really backed in a strong way.


Let's get right into the details of a story that published recently. You and Mike Baker have the bylines on it, and you write that our nation's public health system is an invisible casualty of the pandemic.

Tell us what you mean by that.


Well, before the pandemic, public health officials weren't really in the spotlight. The pandemic, the restrictions that have come with the pandemic, the enormous toll from the pandemic—including more than 700,000 deaths in the United States—have really increased the spotlight on public health officials; and many have found themselves not only receiving some accolades for their very hard work, but many have also found themselves the targets of vitriol, of abuse and harassment and threats. There's been increased scrutiny on the work that they've been doing.


And invisible because it just kind of happened in the background, got overshadowed by all of the fighting over masks and vaccines and everything else.



There's been a lot of talk about frontline workers working at hospitals, which is absolutely true—I mean, hospital workers have been very much on the front line—but public health officials also have been on the front lines trying to make sure that people are getting tested, getting vaccinated, quarantining, or isolating themselves if they're infected or been exposed.


You and your team recently sent out surveys to hundreds of public health departments across the country.

What more can you tell us about that project and what were you looking for?



So, we sent a very extensive and long survey asking about a couple of different thematic areas—staffing, funding, contact tracing, and overall preparedness and trust in the community—to every county health department across the United States. And for some states that don't have county health departments, we sent them to regional health districts. We also contacted state health departments.

So, that ended up being about 3000 departments in total. It was a really long survey, so I actually thought that we probably wouldn't get much of a response. It was a time-consuming survey and it required looking up lots of numbers and not just like a really quick response.

But we actually heard back from almost 300 public health officials covering about 350 counties across the United States, so roughly a bit more than 10% of local health departments across the United States. For anyone who didn't want to spend hours filling out a survey, we talked with them on the phone and talked through. It was still really long—it took at least an hour to get through the survey on the phone.

And we heard really detailed responses about problems with under staffing, problems with losing staff during the pandemic, horrible problems with burnout among staff. We heard about unpredictable funding and frustrations with the money that has been made available. We heard about contact tracing becoming increasingly difficult as pandemic fatigue has gotten worse and worse and worse. And we heard just a lot of desperation for what will be happening in the coming months and how to get out of this hole.


Tomorrow, we'll have more from our conversation with Danielle Ivory, including her reaction to the results of the survey.

The Times report revealed that many departments have received plenty of COVID money, but they've spent it on equipment and supplies because it's temporary—in other words, it isn't enough to support urgent long-term needs, like more staff to handle the workload.

On Capitol Hill, there's movement to provide funding to hire workers and improve support for public health teams. It's all part of the Senate's version of the FY22 Appropriations bills, among them a proposal to bump CDC funding 24%—that's an extra $1.8 billion over FY21 spending levels.


On the policy front, some ASTHO members have been working to better serve those facing partner violence and substance use disorders during the pandemic.

Ramya Dronamraju is a senior analyst on ASTHO's Maternal and Infant Health team.


There have been quite a few states that have enacted legislation and have extended funding towards programs to address intimate partner violence or substance use disorder during COVID.

Since 2020, Colorado has allocated funding towards behavioral health services and substance use disorder recovery centers; but they also passed legislation to allocate funding towards populations disproportionately affected by COVID-19, including those experiencing domestic violence, sexual assault, and other violence.

And additionally, during the quarantine period between March 2020 and July 2020, 17 states explicitly listed survivors of domestic violence or other seeking safety as people exempt from stay-at-home orders so that they would be able to obtain protective shelter.



Finally this morning, two reminders for you.

First, the CDC's Advisory Committee on Immunization Practices meets to consider the Moderna and Johnson & Johnson COVID boosters and to talk about mixing and matching vaccine formulas.

And second, the Great ShakeOut is happening today. The online earthquake preparedness exercise is open to ASTHO members and the public.


Visit the show notes for links to more information about all the stories mentioned in today's report.


Also, remember to follow us on Apple Podcasts or Spotify, or listen on Alexa or Google assistant.

And, if you have a minute, please take time to leave us a rating and a review.


Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.

Ramya Dronamraju MPH

Director, Maternal & Infant Health, ASTHO

Danielle Ivory

Journalist, New York Times