When we think about health care, many of us picture hospitals, doctors’ offices, or high-dollar procedures. But often the most powerful—and cost-saving—work happens behind the scenes: in local public health departments working in our communities.
Pulse Check Points
The hidden value of prevention and community health
Local health departments (city, county, or regional public health agencies) do a lot more than fight pandemics or respond to outbreaks. They engage in prevention, health-promotion, screening, education, vaccination, chronic-disease management, and linking people to affordable care. The CDC describes public health as “the backbone of the public health system.” (State and Local Health Departments: Research, Surveillance, and Evidence-Based Public Health Practices)
For example, they might run programs for smoking cessation, nutrition (e.g. vouchers for fresh produce), immunizations, screening for high blood pressure or diabetes, etc. These interventions help catch health problems early — or prevent them entirely — which means fewer people wind up with serious conditions that require expensive emergency or hospital care.
By reducing chronic illness and preventing disease, local public health reduces the number of avoidable emergency department (ED) visits — a major driver of health-care costs.
A movement to bring together Emergency Medical Services and Public Health is gaining traction as well in hopes of bringing down overall health costs. When people lack access to primary care they use 911 services in non-emergency situations. The organizations are partnering to identify clients in rural areas who need non-emergency services including addressing loneliness through proactive public health outreach. Public health workers establish relationships with the clients and work with them on prevention and providing resources other than EMS for non emergencies.
Santa Clara County, CA launched the 911 Nurse Navigator Pilot Program to redirect non-emergency 911 calls to a team of nurses who can determine the right next steps and resources to manage the non-emergency calls.
The high cost of avoidable emergency care
Emergency departments in the U.S. see hundreds of millions of visits per year. According to recent data, the national ED visit rate in 2022 was 47 visits per 100 people — representing roughly 155 million ED visits in that year alone.
Many of these visits are not true emergencies. According to Behavioral Health News, as many as 48% of ER visits in a state like New York were for routine or non-emergency care that could have been provided by community health providers or other non-ED settings. When people use the ED for non-urgent issues, it drives up costs — both for the patient and society as a whole — and diverts resources from true emergencies.
The cost difference is significant: According to an article from Johns Hopkins, a 2017 average ER visit cost was estimated at $1,389. Multiplied across millions of potentially avoidable visits, that represents a huge—and often unnecessary—expense.
Local public health works: reducing ED visits through alternatives and coordination
According to MedCity News, “Community health programs provide proactive solutions to challenges such as frequent falls, chronic conditions, or the needs of underserved populations. By identifying and addressing gaps in care, these initiatives reduce 911 calls, prevent hospital readmissions, and align resources more effectively to improve patient outcomes.”
A study published in the American Journal of Emergency Medicine showed a 44% reduction in risk of visits ED visits through implementation of mobile integrated health-community paramedicine programs.
Some specific examples:
- Programs that integrate community health workers (CHWs) or care navigators into primary care teams can cut down on repetitive ED visits and hospitalizations among patients with chronic diseases — and can be cost-effective or even cost-neutral from the payer’s perspective. (Benchmarks for Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care, 2016).
- Local public health agencies help coordinate with Emergency Medical Services (EMS) during outbreaks or emergencies — sparing the need for larger, expensive state or national mobilization.
- Community-based interventions (food voucher programs, tobacco cessation, screenings, etc.) help address root causes of poor health (social determinants), yielding long-term improvements in chronic disease outcomes.
A well-funded, well-integrated local public health infrastructure keeps people healthier — and keeps them out of the ER and hospital whenever possible.
Why this matters to all of us — including taxpayers
Because so much of our health-care spending is reactive (hospitalizations, emergency care, acute crises), we end up paying a premium — in taxes, insurance premiums, or out-of-pocket costs. When local public health prevents disease and reduces unnecessary ED usage, that lowers overall spending.
Moreover, when fewer people rely on emergency departments for routine or preventable conditions, hospitals can focus their resources on true emergencies — improving responsiveness, reducing overcrowding, enabling better staffing and outcomes for serious cases.
For taxpayers and insurance-payers alike, prevention through local public health is one of the smartest, most cost-efficient investments.
Local health is not just for "other people"
Sometimes public health gets dismissed as something only for “other people,” or only for vulnerable populations. But the truth is: everyone benefits when our community is healthier. When public health keeps outbreaks from spreading, ensures immunizations, supports healthy environments (clean water, safe food, sanitation), and helps prevent chronic disease — it lowers risk and cost for all of us.
It also levels the playing field: preventive care and community-based support help people who might otherwise skip care until things get critical. That benefits society as a whole.
How you can support local public health
Supporting local public health doesn’t always require major policy reform — it often begins with simple, community-level actions. One of the most meaningful steps you can take is to reach out to your local health department and ask what they need, what programs they are working to sustain, and how community members can get involved. Many departments rely on volunteers, community partnerships, and public awareness to keep vital prevention and education programs running.
These local efforts matter nationally as well. Strengthening the public health and nursing workforce — the backbone of community health — is essential to maintaining the prevention, coordination, and equity work that keeps communities healthy and reduces avoidable health-care costs. You can support this effort by signing the American Nurses Association petition to protect nursing as a recognized profession and preserve essential educational standards: https://ana.quorum.us/campaign/professionaldegreepetition/
As debates about health-care costs continue, it’s important to recognize that one of the most effective tools for keeping care affordable — and humane — is the quiet, everyday work of our state and local health departments. Every dollar invested in prevention, community health, and coordinated services can save many times that in avoided emergency visits, hospitalizations, and long-term disease burdens.
Supporting local public health means supporting a health-care system that works for everyone and doesn’t allow preventable issues to become costly crises. Whether by engaging with your local health department or advocating nationally for a strong nursing workforce, these concrete actions help ensure that public health has the visibility, resources, and policy support it needs to protect community well-being.
Resources for Local Health Departments
If you need a way to document the valuable care you provide for individuals, families, communities, and through partnerships with local organizations, consider Champ Software’s comprehensive agency management system: www.champsoftware.com