This article was originally posted on Philly.com.
If budgets reflect values, Philadelphia doesn’t place a high value on the health of its residents. On Tuesday, City Council held budget hearings for the Department of Public Health, Department of Behavioral Health and Intellectual Disabilities, and Department of Homelessness Services. All departments basically asked for no major increases in budgets.
If all three departments get the funding that they asked for — a grand total of $234 million — the city’s direct investment in health and homelessness will be just under 5 percent of the total $4.9 billion in the General Fund that is projected for fiscal year 2020. For reference: Pensions and benefits cost $1.4 billion, comprising 28 percent of the budget.
That’s a problem because Philadelphia is not a healthy city.
According to the Health of the City report by the Department of Public Health released early this year, life expectancy in Philadelphia is declining (72.4 for men and 79.7 for women) and one in five adults is obese as are one in three children. While the final figure of overdose deaths for 2018 is not yet released, preliminary reports estimate only a slight reduction in overdose death from 1,217 to 1,100. In addition, 102 people were killed in a homicide already this year. The latest State of the City report from the Pew Charitable Trusts reveals that more than 1,000 homeless people live on the streets of Philadelphia.
The poor health of Philadelphia is not shared equally — the lives of brown and black Philadelphians are more vulnerable to sickness, injury, and early death.
To be clear, this is not an indictment of the departments tasked with bettering the city’s health. It does, however, raise questions about whether the city has a comprehensive vision on how to turn the tide — and whether we are meeting the crises of the day with the seriousness that they deserve.
The city has been faring worse on many health indicators over the past four years — overdose deaths increased dramatically, street homelessness nearly tripled, new HIV diagnoses among people who inject drugs doubled, adult obesity increased, and so did homicides. And yet, there hasn’t been a significant shift in resources to the three departments that address these issues — even though at the same time the budget increased by a billion dollars. For reference: The budget for the fire department increased by $79 million, while the budget for the three departments combined increased by $54 million.
The city’s health budgets don’t reflect the full response to our health problems; for example, the school district invests money in children’s health, and the police take an active role in homicides. State and federal grants provide additional health resources, though many of those resources are declining. But one of the most fundamental responsibilities of local government is to ensure its residents are alive and healthy. If we are in the midst of a public-health crisis, and we are, the mayor and City Council should make sure the budget reflects that reality.