In the decade before Michigan and its largest city became the latest hot spot for the deadly coronavirus, officials were steadily, and at times dramatically, cutting back on their first line of defense against pandemics and other public health emergencies. Approaching bankruptcy, Detroit disbanded most of its public health department and handed its responsibilities to a private nonprofit. When the department reopened in 2014 in the back of the municipal parking office, its per capita budget was a fraction of other big cities’, to serve a needier population. In Ingham County, home to the capital city of Lansing, then-Public Health Director Renee Branch Canady sat down at budget time every year for seven straight years to figure out what more to cut. “It was just chop, chop, chop,” Canady said. By the time she left in 2014, all the health educators, who teach people how to prevent disease, were gone. What happened in Michigan also played out across the country and at the federal level after the 2008 recession, which caused serious budget problems for governments. But as the economy recovered, public health funding did not, a review of budget figures and interviews with health experts and officials shows. A

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