Shortchanging America’s Health

A State-by-State Look at How Public Health Dollars Are Spent

A March 2010 report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) found 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. These cuts leave communities around the country struggling to deliver basic disease prevention and emergency health preparedness services.

A March 2010 report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) found 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. These cuts leave 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.

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 Americas 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.