Guest blogger David Fleming, MD, Director and Health Officer
Public Health-Seattle & King County

Ask Magan Cromar the value of Maternity Support Services (MSS) and tears will fill your eyes as she describes the life-preserving services she and her daughter received.  Magan had to leave her job after her daughter Sophie was born with special needs. A public health nurse visited their home in Issaquah twice a week to check on Sophie’s health and ultimately helped them through a health crisis that prevented an invasive and risky surgery for Sophie. Now that Sophie is a happy, healthy two-year-old, Magan will tell anyone who asks how invaluable MSS was to her daughter and her family.

Each year, more than 230,000 people in King County rely on community and public health centers for their medical and dental care. More than one-third are uninsured and nearly all are low-income.

But programs like MSS and other safety net services are at risk for reduction or elimination due to the state budget crisis. Among the budget cuts amassing in the health care system, the public and community health center system stands to be among the hardest hit.  Six community health centers in King County – Country Doctor, Neighborcare Health, International Community Health Services, Seattle Indian Health Board, HealthPoint, and Sea Mar – along with Public Health – Seattle & King County provide care at more than 30 locations countywide, delivering high quality, cost-effective preventive and primary care.

Under the proposed state budget for 2011-13, deep cuts are expected to lead to reduced services and some clinics may close. The dismantling of our preventive and primary care safety net will cost us all more, through more expensive emergency room and hospital visits, the need for more jail health services, and the consequences of untreated illnesses. 

Effects of state and federal budget cuts will impact other safety net services across King County, as well.  Affordable housing and community development will be impacted, along with numerous human service programs. 

Inequities in King County are already among the most extreme in the country.  While some communities enjoy significant wealth and good health, others have health outcomes that mirror those of developing countries.  Not surprisingly, those differences fall right along racial and socioeconomic lines. Cuts to programs like the federal Community Development Block Grant and inadequate support for the state Housing Trust Fund slow countywide efforts to eliminate inequities.

Even with the crises facing our health, education, and community support systems, we must keep at the forefront the vision of King County as a diverse and dynamic community with a healthy economy and environment where all people and businesses have the opportunity to thrive.  If there is any opportunity in this economic crisis, it is the chance to innovate and become even more effective as we work to rebuild our health and safety net systems—continuing to move us all toward better health.