New report: Federal spending for public health flat for nearly five years

Flat Federal Funding and Cuts in States Put America's Health At-Risk

Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) today released a new report, Shortchanging America's Health: A State-By-State Look at How Public Health Dollars Are Spent, which finds federal spending for public health has been flat for nearly five years, while states around the country cut nearly $392 million for public health programs in the past year, which leaves communities around the country struggling to deliver basic disease prevention and emergency health preparedness services.

States in the Midwest received the least federal funding support for disease prevention at public health, at only $16.50 per person in fiscal year (FY) 2009, according to the analysis.  This is $3.30 less per person than the Northeastern states, which receive the highest amount, at $19.80 per person. Western states receive $19.22 per person, while Southern states receive $19.75 per person.  

"Chronic under funding for public health means that millions of Americans are needlessly suffering from preventable diseases, health care costs have skyrocketed, and our workforce is not as healthy as it needs to be to compete with the rest of the world," said Jeffrey Levi, PhD, Executive Director of TFAH.  "If we are going to improve the health of Americans, we need to fundamentally rethink our approach to funding and managing public health and disease prevention in the United States."

States are expected to cut budgets even more in the coming year, which will further limit the ability of public health departments to carry out services for:  

• Cancer, diabetes, obesity, and other chronic disease prevention;
• HIV/AIDS, MRSA, TB, and other infectious disease prevention;
• Food and water safety;
• Environmental health improvement; and
• Bioterrorism and health emergency preparedness.

Other key findings in the Shortchanging America's Health report include that:

• Federal funding to states from public health from the U.S. Centers for Disease Control and Prevention (CDC) averaged out to only $19.23 per person in FY2009. The amount spent to prevent disease and improve health in communities ranged significantly from state to state, with a per capita low of $13.33 in Virginia to a high of $58.65 in Alaska. Approximately 75 percent of CDC's budget is distributed through grants or cooperative agreements to states and communities to support programs to prevent diseases and prepare for health disasters.
• State funding for public health ranged dramatically across the country, from a low of $3.55 per person in Nevada to a high of $169.92 per person in Hawaii.  The national median is $28.92 per person.  The structure of state and local health departments varies from state to state, with some states relying more on local funds.  

"Public health departments are responsible for finding ways to address the systemic reasons why some communities are healthier than others and for developing policies and programs to remove obstacles that get in the way of making health choices possible," Levi said.  "But right now, public health departments do not have the resources they need to improve health in communities.  Our ability to address the geographic and racial/ethnic disparities in health is limited by our failure to invest adequately in creating a modernized public health system."