OXFORD, N.C. -- North Carolina has spent fewer and fewer dollars on public health over the past decade, and local health officials say inconsistent funding has led to reduced staff and resources, which likely worsened the fallout from the pandemic.

Data from Kaiser Health News show spending for the state's 85 local health departments dipped by more than 27% between 2010 and 2018.

Lisa Macon Harrison, vice president for the National Association of County and City Health Officials and health director for Granville-Vance Public Health, said most departments rely on a patchwork of disease-specific grant funding and federal dollars from the Centers for Disease Control and Prevention.

"There's also not a full appreciation of the mandated services and restrictions our system asks of us, and the lack of flexibility," Harrison pointed out. "We have to sometimes be able to pivot and be as nimble as we'd like to be in situations like we're in now, where we are managing change every single week."

According to research by Trust for America's Health, public health represented just 2.5% of all U.S. health spending in 2017.

The report also found, nationwide, public-health surveillance infrastructure for detecting infectious diseases and environmental threats hasn't kept up with current technologies and are in dire need of upgrades.

Meanwhile, the state's population grew to an estimated 10.5 million people as of July 1, 2019, the fourth year in a row North Carolina has grown by more than 100,000 people, according to the latest data from the U.S. Census.

Jason Baisden, senior program officer for the Kate B. Reynolds Charitable Trust, said policymakers should view public health as a critical part of the state's healthcare safety-net infrastructure.

"Investments today in our public health infrastructure and things like housing have dividends for improved health," Baisden asserted. "And we believe, lower cost, in the long-term, and it's a discussion that North Carolina and North Carolinians need to have."

Harrison noted she's grateful more residents are becoming aware of the services their local health departments provide as COVID-19 vaccinations ramp up, but she argued communities need long-term, sustainable solutions.

"But it also calls our policymakers to action to make sure that we are able to not only survive as an infrastructure through this pandemic response and vaccination program, but that we thrive enough to prevent it from happening again," Harrison contended.

She pointed out in addition to meeting residents' basic health needs and providing immunizations, public-health departments work to prevent the start and spread of outbreaks, monitor food safety in restaurants and other public places, keep drinking water clean, and respond to natural disasters and emergencies.

A new report on lung cancer by the American Lung Association showed Maryland has quite a bit of room to improve diagnoses and treatment but experts said the state has taken some big steps in tackling it.

The report showed almost 17% of Marylanders at high risk for lung cancer were screened, a little less than the national average. Maryland fared better in other metrics, including lower rates of adult smokers and people unable to access treatment.

Aleks Casper, Maryland director of advocacy for the American Lung Association, said to improve the state's standing, Marylanders at risk of lung cancer need to be screened at higher rates.

"If we can get people screened, our chances of impacting all the other metrics improve," Casper explained. "If we get people screened and we can find it early, then we can connect them to treatment and we can connect them to surgery, which impacts outcomes."

The report also noted Latinos in Maryland are the least likely group to be diagnosed early.

Casper pointed out certain policies in Maryland have removed barriers to diagnosis and treatment. Just this year, Maryland became one of 15 states to require insurance to cover biomarker testing, including for lung cancer. The National Cancer Institute described biomarker testing as using a sample of tissue, blood or other fluid to look for genes or chromosomes which could increase a person's likelihood of developing certain cancers, which Casper emphasized is critical.

"Being able to test and determine what the best type of treatment for that person's disease, that kind of really individualized care and giving people access to that, is really important," Casper added.

Those who want to find out if they're eligible to be screened for lung cancer can take a quick test at savedbythescan.org.


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By Kyla Russell for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

Walking pneumonia cases in central Indiana have seen a steep increase in recent weeks, local physicians say.

"But what we've seen this summer, starting in July and August, was an explosion in the number of cases," said Dr. John Christenson, associate medical director of infection prevention at Riley Hospital for Children. "Some require admissions to intensive care units. Children die, adults die .. sometimes it invades the brain and it can cause an infection there."

Walking pneumonia is generally considered less severe than pneumonia, but can have lasting impacts if not caught early on. The disease is caused by mycoplasma pneumoniae, which can damage the lining of the respiratory tract, according to the CDC.

It is spread through droplets released when someone coughs or sneezes.

"Symptoms can begin mildly with sore throat, cough, or chest pain," Christenson said.

About two million people are diagnosed with the disease each year. This year is different, though.

While it's common for young children and adolescents to be impacted, small children born during the Covid-19 lockdown are seeing a surge in cases.

The CDC said diagnoses in kids between two and four years old jumped from 1% to 7.2% over a six-month time span this year.

"We saw a rebound after Covid," Christenson said.

During lockdown, people were wearing masks, staying home, and were not at school and work.

"What happened was a lot of people who could acquire an infection around that time, didn't," Christenson said. "So, now they're all susceptible. You bring in a new germ or an old germ into an environment and it spreads like wildfire."

Several local schools have seen an increase in students, asking parents to be on the lookout for symptoms and to take their child to a physician if needed.

As holiday gatherings begin, Christenson is heeding a similar call, especially in severe cases.

"That's when you need to take them to their healthcare professional to have them seen, and in some cases, get X-rays," Christenson said.

Additionally, Christenson said it is important to make sure families are up-to-date on all vaccinations.


Kyla Russell wrote this article for WISH-TV.


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More than one in three children is now overweight or obese, according to new research published in the Lancet medical journal.

The study found while Kentucky and other southern states are forecast to continue seeing rising levels of childhood obesity, some other states, such as Utah, will experience even higher spikes.

Ben Chandler, CEO of the Foundation for a Healthy Kentucky, said the Commonwealth is struggling to address health care and quality of life for kids.

"I think we're 45th in being overweight," Chandler observed. "It leads to a shorter life expectancy. It leads to tremendous spikes in the odds of getting any number of diseases and it has a huge cost attributed to it. "

Almost half of teens and young adults now are either overweight or obese, compared with 29% in 1990. The number is expected to jump by between 31% and 50% for adolescents, and by 29% to 33% for kids ages 6-11.

Chandler argued the state should increase funding for physical activity programs in schools and address the persistent lack of access to healthy and affordable fresh food. He added the issue cannot be tackled solely through individual behavior changes.

"There are a lot of environmental factors that are involved here," Chandler pointed out. "There's a lot of money, quite frankly, being spent in advertising for things that are bad for you."

The study also found among U.S. adults, if the current pattern continues, more than 250 million people will be overweight or obese by 2050.