As final negotiations ramp up on the state budget, policymakers still have an opportunity to increase essential local public health funding, which supports local health departments’ delivery of core public health-related services and programming.

Greater public health investment in Michigan is sorely needed. Even when combined with federal funding, limited state investment results in $83 in per-capita public health spending, which ranks Michigan 40th in the nation.

Public health is broad and impactful to our everyday lives. It encompasses infectious disease control, environmental safety, health behavior change, quality food and water, in addition to social determinants of health — or non-medical factors influenced by the conditions in which people are born, work, age and live.

In addition, because public health prevents disease from occurring in the first place, it tends to work invisibly, and success is often measured when disease doesn’t occur at all.

In fact, if Michigan lawmakers want to keep their constituents safe and healthy, a proactive and preventative approach to local public health funding must be a part of our “new normal” as we look beyond the COVID-19 pandemic.

To be clear, “safe and healthy” is much broader than not being hospitalized or dying from COVID-19. All 45 local health departments (covering all 83 counties) are required to provide Essential Local Public Health Services (ELPHS), which is core public health programming across seven different areas. In addition, local health departments connect families to affordable health care, collect and analyze local health data, and provide many services focused on children’s health by both conducting the majority of Women, Infants, and Children programs across Michigan and participating in the Children’s Special Health Care Services program.

But, over the past two years, all local health departments have had to shift resources away from this regularly scheduled programming to prioritize managing the COVID-19 pandemic and saving lives in their communities.

Local health departments have operated with limited funding for longer. While public health appropriations in Michigan have increased overall since 2010, state ELPHS funding has remained relatively stagnant, even despite recent boosts, including flat funding from 2015 to 2018.

Research has shown that local health department spending is some of the most effective public health spending, linked to the delivery of essential services, stronger public health system performance, and reduced deaths, overall. But local health departments have continued to go without tens of millions of additional state dollars, which would better support their delivery of essential services across Michigan. Without additional investment, basic public health functions, services and systems suffer as health departments have to do more with less, and that can mean worse health outcomes across Michigan’s communities.

Ultimately, that lack of public health investment has a detrimental impact on Michiganders’ health.

Based on America’s Health Rankings, Michigan does well on clinical care factors. But it is clear that our state is neglecting other changeable health factors, like social determinants of health, by not investing in policies, programs and capacity — particularly at the local level — that support health factors outside of clinical care.

In addition, systemic barriers like geographic and economic segregation as well as institutional racism push social and economic resources that improve health outcomes further from reach for Michigan’s communities of color, which contributes to racial health disparities. Critically, those disparities are not inevitabilities and strategic policymaking and funding can shift health outcomes.

Unfortunately, all proposed fiscal year 2023 budgets have actually reduced state spending on ELPHS by nearly $2 million.

There is still time to advocate for that priority and urge your lawmakers to ensure that final budget negotiations include a much-needed boost for local public health.

Proactive investment in local public health systems through ELPHS must happen now if we hope to see better health outcomes in our state’s future.

Simon Marshall-Shah is a policy analyst at the Michigan League for Public Policy.