The Reorganization of the CDC and Its Impact on NIOSH: Critics of the Reorganization Plan for the Centers for Disease Control and Prevention Worry That the National Institute for Occupational Safety and Health Could Get Lost in the Shuffle
Nash, James L., Smith, Sandy, Occupational Hazards
The reorganization of the Centers for Disease Control and Prevention (CDC) moves NIOSH into a new Coordinating Center for Health Promotion. The changes evolved from an ongoing strategic development process called the Futures Initiative, which began 1 year ago at CDC and includes hundreds of employees, other agencies, organizations and the public.
CDC Director Julie Gerberding said CDC will align its priorities and investments under two health protection goals:
Preparedness: People in all communities will be protected from infectious, environmental and terrorists threats.
Health Promotion and Prevention of Disease, Injury and Disability: All people will achieve their optimal lifespan with the best possible quality of health in every stage of life.
In addition, the agency is developing more targeted goals to assure an improved impact on health at every stage of life including infants and toddlers, children, adolescents, adults and older adults.
CDC's existing operational units will be organized into four coordinating centers to help the agency leverage its resources to be more nimble in responding to public health threats and emerging issues as well as chronic health conditions. The directors of the coordinating centers will report through a new layer of management, called "executive leadership," to the CDC director.
"Our aim is to help ensure that all people are protected in safe and healthy communities so they can achieve their full life expectancy," said Gerberding.
In an interview, NIOSH Director John Howard said that before the reorganization, NIOSH, along with a dozen other centers, offices and institutes, maintained a semi-autonomous status within CDC and reported directly to the CDC's director.
"All these different offices, centers and institutes had administrative structures and missions, and some of these are duplicative," asserted Howard. He added that in the current budget climate, CDC's funding is expected to rise by only 2 or 3 percent next year. "We're hoping that by avoiding duplication we can put that money into programs and enhance our impact.
"My job will remain the same, to manage programs, and I will still report to the director of the CDC," said Howard.
While Gerberding and Howard seem optimistic about the future of CDC and its operating units, others aren't so certain the move is a good one.
Occupational safety and health organizations, labor unions, academics, independent consultants and staff members from the Center for Disease Control and Prevention (CDC) are expressing opposition to the reorganization, because they believe the change will dilute NIOSH's research capabilities.
In a June 17 letter to HHS Secretary Tommy Thompson, the American Society of Safety Engineers (ASSE) voiced opposition to the move, and suggested it may be time to move NIOSH from HHS to the Department of Labor.
"If these organizational changes proceed as proposed, they may signal an inability on the part of HHS and CDC to provide the necessary dedication to worker safety and health," ASSE President James Kendrick wrote.
A primary concern of critics of the reorganization plan is that NIOSH will go from an agency reporting directly to the head of the CDC to an agency under the direction of interests that have no demonstrated commitment to occupational safety and health issues.
AIHA President Donna Doganiero, CIH, said that organization has always been supportive of efforts to streamline government agencies, especially when it can have a positive effect on worker health and safety. "However," she added, "we have concerns about the potential impact of the CDC reorganization."
Doganiero said AIHA is concerned about "the loss of the direct reporting relationship between NIOSH and the director of CDC; the potential loss of funding for NIOSH in its new coordinating center; and the possibility of reduced interaction between OSHA and NIOSH. …