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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

State funding a major concern for local public health agencies in Missouri

Bram Sable-Smith
Columbia/Boone County Health and Human Services is a member agency of the Missouri Association of Local Public Health Agencies.

The Missouri Association of Local Public Health Agencies (MoALPHA) was founded in 1994 to support the  city and county public health agencies in the state. I spoke with the incoming chair of the association, Gary Zaborac, about the public health challenges facing Missouri in 2015.

This interview has been condensed and edited for content and clarity.

In addition to being chair of MoALPHA, you are also the Director of Public Health at the Clay County Public Health Center. What are you hearing from your peers and what are you seeing to be the biggest public health challenges this coming year?

Well I think there are a number of challenges in the upcoming year, as a matter of fact to get a better handle on that we are going to be surveying the membership in January and February. But I can tell you from our general conversations at meetings probably the biggest is the lack of state funding for local public health in Missouri. We currently rank 51st in state funding for public health in the United States and we actually have had such a significant cut over the last few years that we've actually gone from around $10 million [in state funding] in 2002, we're down to $2.3 million in 2014. That's a significant cut and it gets reflected in our ability to provide those services that we're expected to provide.

How does public health funding affect health outcomes in the state?

There's a direct correlation that we're seeing here in Missouri that our health outcome rankings are declining. As a matter of fact, we're now 42nd, for example, in heart disease outcomes. That basically means that there are only nine other states that are worse than Missouri in that category. We're 38th in cancer. And those rankings are getting worse, unfortunately. So from that big picture balcony perspective I think the lack of preventive funding in Missouri is catching up to us in terms of the health outcomes and I think we're seeing that.

What else will you be focusing on in the coming year and in your term as chair of MoALPHA?

As I said we're going to be surveying the membership. Probably the biggest focus for me in the upcoming year is after we get that assessment is to then step back and take a look at the landscape and look at all the serious challenges that are facing us including funding. We're no different than anybody else, we need resources if we're going to be expected to meet our mandates and so if we aren’t given the resources then we have to continue to prioritize. And prioritize really means looking at, ‘well okay what can you afford to do and what can you not afford to do.’ And that usually means services go away.

A curious Columbia, Mo. native, Bram Sable-Smith has documented mbira musicians in Zimbabwe, mining protests in Chile, and the St. Louis airport's tumultuous relationship with the Chinese cargo business. His reporting from Ferguson, Mo. was part of a KBIA documentary honored by the Missouri Broadcasters Association and winner of a national Edward R. Murrow Award. He comes to KBIA most recently from the Salt Institute for Documentary Studies in Portland, Maine.
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