The local public health workforce has declined by an estimated 15% in the past two years, including 16,000 jobs lost in 2009, according to a survey released today by the National Association of County and City Health Officials. "The cumulative effects of budget cuts and job losses have taken a major toll on the ability of health officials to respond not only to large-scale emergencies and disease outbreaks like H1N1 influenza, but to the everyday situations for which the health department is the first line of defense," said NACCHO Executive Director Robert Pestronk. In related news, a report released today by Trust for America's Health and the Robert Wood Johnson Foundation found Midwestern and Southern states received less federal funding for disease prevention programs than Northeastern and Western states in fiscal year 2008.