Invest in the systems that keep us healthy and divest from the systems that harm

Governor Gavin Newsom has released the May Revised Budget, cutting billions in spending to address California’s staggering and unpredictable budget deficit. While his original budget spared many key public health initiatives from the chopping block, Newsom’s revised budget cuts $52.5 million from last year’s local and state public health funding, and an additional $300 million in ongoing spending reductions.

Dwindling federal support for efforts to confront an ongoing pandemic has left our communities on the brink, struggling to recover from COVID-19’s far-reaching impacts. This crisis has highlighted the lethal outcomes of long-term neglect in public health investment—spanning from health departments to broader social supports necessary for a healthy life, including affordable housing, stable employment with fair wages, and robust climate resilience measures. Now, more than ever, our approach to budgeting must be forward-thinking and interconnected, prioritizing a holistic understanding of our state’s needs that addresses both current challenges and historical oversights.

We need to do more. Strong leadership that is data-informed and values-driven is absolutely necessary to improve the health and well-being of everyone who calls California home. As public health professionals, we’re all too aware of the dire consequences stemming from inadequately funding basic human needs and social services, like housing and education. While sparing some key healthcare initiatives from the chopping block is commendable, avoiding major cuts isn’t enough. It’s vital we make substantial investments that fortify our social safety net.

A vast body of research documents the importance of access to quality housing, employment, transportation, and healthcare. Data show that unhoused people are “more likely to become ill, have greater hospitalization rates, and are more likely to die at a younger age than the general population.” Houselessness can result in respiratory conditions, depression, anxiety, unintentional injury, excess winter mortality, and skin irritation. California is in the midst of a long-term housing crisis, with over 181,000 unhoused people – the highest rate of unhoused people in the country. Meanwhile, Newsom is proposing over $1.2 billion cuts to the General Fund towards housing.

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Research also finds that unemployment has harmful impacts on physical health, including associations with worse self-reported health, more cardiovascular disease, an increase in hospitalization, higher use of medical services, and higher rates of mortality. One study found that losing one’s job doubled the risk of stroke for workers. California currently has the highest unemployment rate in the country at 5.3%. Meanwhile, Gavin Newsom is proposing a 28% reduction in labor and workforce development funding, including cutting $10 million from EMT training programs.

Finally, we know that climate justice is essential to maintaining health and well-being for everyone. Pollution is commonly understood as the largest environmental determinant of health, contributing to the development of conditions such as cancer, cardiovascular and respiratory diseases, and immune system disorders. This is a health equity concern, especially as low-income people, people who live in rural areas, and people of color disproportionately live in or near climate-vulnerable areas and lack the resources needed to migrate a climate emergency. San Francisco was recently ranked as the city with the highest chronic risk from climate hazards. Meanwhile, Gavin Newsom has proposed cutting funding to Environmental Protection by over half in the 2024 budget.

Instead of cutting human needs and social services, we can divest from systems of incarceration, which the American Public Health Association has named are harmful to health, and that disproportionately impact communities of color and other marginalized people. In addition to the extensive research clearly stating the health harms of investing in incarceration, there are economic benefits from the divestment of incarceration. The State’s own Legislative Analyst’s Office has concluded that closing five prisons in California would result in $1.5 billion in annual savings alone. While we know prison closure won’t solve the immediate budget crisis, the long-term benefits will be monumental and ultimately protect the well-being of all Californians.

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Meanwhile, Newsom’s revised corrections budget remains over $18 billion. This includes about $14 billion in funding for the California Department of Corrections and Rehabilitation (CDCR); about $2 billion for local community corrections; over $800 million for enhancing law enforcement growth; and $1 billion in raises for corrections officers over the next three years. It would cost $11 billion to repair the state’s 12 oldest prisons rather than close them. Despite this, Newsom’s May Revise only makes minimal cuts to CDCR’s bloated budget, saving a mere $80 million by deactivating some prison housing units.

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Amid billions of cuts to vital social safety nets—healthcare, public health, housing, climate justice, and workforce development—CDCR’s budget remains largely untouched. Why is Newsom unwilling to make cuts to this harmful system? While some may argue otherwise, there is little to no evidence that increased spending on policing and corrections improves community safety. Indeed, Newsom’s shift to the right on criminal legal system policies may lose him the support of the progressive left, especially among young voters who are already demanding a course correction from our elected officials.

We need smart solutions to safety that don’t rely on wasteful spending on incarceration that only create further harm. Closing state prisons that are no longer needed with shrinking prison populations is a pragmatic first step to reduce long term spending. Instead, the current budget cuts to important programs, which prevent incarceration by fostering community wellness and safety, could set California on a path to filling state prisons back up.

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Public health research is clear: California urgently needs to refocus on the well-being of our communities by investing in the systems that keep us healthy, and divesting from the systems that harm.

Christine Mitchell and Renae A. Badruzzaman are co-directors of the Health Instead of Punishment Program at Human Impact Partners.

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