By Ryan Talen

As a nurse, I workat a hospital for long hours on weekdays and weekends. I wake up early and spend 12 hours at Harborview, the regional public trauma center for Washington, Alaska, Idaho, and Montana. It’s the area’s safety-net hospital, where we take everyone who comes through the door regardless of their ability to pay.

My patients span the socioeconomic spectrum: Some are well off, some are middle- or working-class, and some are experiencing homelessness. All of them benefit from public health investments. Whether they rely on vaccine information, restaurant health inspections, or the incredible free dental, vision, and health clinics Public Health-Seattle & King County offers, all my patients are healthier when they come to me because of these local investments.

So when I saw King County Executive Girmay Zahilay’s proposed budget cuts to the health department, I had serious questions about his priorities. Earlier this month, the Executive sent the King County Council a budget proposal that cuts approximately $2.8 million from the Department of Public Health while spending more than $18.7 million on his return-to-office proposal.

In the scheme of a county budget, $2.8 million could come across as budget dust. But as a nurse at Harborview who witnessed repeated cuts to public health care since the peak of the pandemic, and who is currently worried about the federal Medicaid cuts that will impact my patients, I want to see deeper investments in public health. Instead, for every dollar cut from public health, Executive Zahilay is proposing nearly seven dollars for office space.

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Because of Executive Zahilay’s budget proposal, I suspect the chance that I will see some rare patient types will increase. When I see cuts to the Monkeypox Vaccine Effectiveness program, I think about the individuals with monkeypox that I have cared for in the past and worry about the potential for seeing more of them. When I read about cuts to the Adult Dental Program, I worry about all the people who will attempt to live with tooth infections until they arrive at my hospital septic and in need of emergency care.

Executive Zahilay’s public health budget cuts come as the federal administration has cut funding for disease surveillance and outbreak response at the CDC, Medicaid coverage for our immigrant and refugee community members, and Affordable Care Act subsidies for millions of Americans. Many King County residents will now delay care because of cost, and when patients put off preventative care, they suffer long-term health consequences. With measles spreading and our food supply less safe, we need state and local governments to invest in public health like the necessity it is.

Because our Public Health Department is funded through the county’s general fund, which has continued to face significant funding shortfalls, it has taken deep cuts in previous budgets. After the health department carried King County through the pandemic with fewer COVID deaths and lower spread than other counties, it’s being rewarded with repeated hits to the budget. I expected a new executive with a progressive platform to take a new approach that prioritizes the health of our community. Instead, King County residents get a proposal that could jeopardize our health.

I urge Executive Zahilay and the King County Council to put people and health first. I know local governments cannot fully backfill the federal spending that’s being cut, but the county can still choose where its own scarce dollars go. The King County Council should reject this unnecessary spending on office space and redirect those dollars to fill the gaps the federal government has created, starting with the public health programs this budget proposal cuts. When hard choices have to be made, don’t invest in office space; invest in public health.

Ryan Talen is a nurse at Harborview, the regional trauma center for Washington state, Alaska, Idaho, and Montana.