Last Sunday, The New York Times reported on an outbreak of pertussis – otherwise known as whopping cough –in Washington state. Public health and state officials have declared an epidemic – with 10 times more diagnosed cases than last year and an incident rate that is closing in on rates encountered in the 1940s. While no deaths have been reported, the last time pertusssis infected as many people (on a per capita basis) was in the 1940s. It was a dreaded, and often lethal disease.
So why does all this matter? Washington state may very well be a canary in a coal mine. In a recent federal study, Washington led the nation in parents who refused vaccinations for their children on moral or religious grounds. Last year, the Associated Press found that Colorado had the second-highest rate of vaccine refusals. Vaccinations as a mode of prevention require a very high compliance rate. Without a high adherence rate, we leave ourselves open to outbreaks like the one in Washington.
Other important policy issues are at play too. Public health departments, strapped for funds, cannot provide free or subsidized vaccinations to poor and vulnerable populations. School nurses are overly taxed – too few man hours and too many cases – and are maxed out as well. It’s the intersection of a health crisis and budget crisis that has put the state in jeopardy.
The supplement to this year’s annual Colorado Health Report Card, "Prevention: Strong Investments in Colorado's Health,", produced in partnership with The Colorado Health Foundation, sheds light on the importance of prevention as a way to better health. Investments require a longer term, strategic rationale: investments today yield lower costs and better outcomes tomorrow. It’s a hard sell in these tough economic times. We only need to look to Washington state to see the potential impact of shorter term budget cutting measures.