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Biosecurity BriefingTFAH Reports Disparities, Reductions in Public Health Funding By Crystal Franco, April 4, 2008 On April 2, 2008, Trust for America’s Health (TFAH) released a new report titled Shortchanging America’s Health, 2008: A State-By-State Look at How Federal Public Health Dollars are Spent. In order to determine the state of the nation’s public health system—including how, and how well public health dollars have been spent—the TFAH report examines both federal and state funding for public health as well as key health indicators such as obesity, asthma, and diabetes and total per capita public health spending for each state.1 According to TFAH, federal public health funding (through CDC grant dollars) “varies, often significantly,” from state to state. FY2006-2007 per capita federal funding for states ranged from a low of $13.61 in Kansas to a high of $69.76 in Alaska, with a national average of $17.23 per person. State funding for public health initiatives is more difficult to calculate (due to differences in state reporting mechanisms). However, TFAH reports that the FY2006-2007 median public health expenditure for states is $33.26 per person with a high of $153.66 per person in Hawaii and a low of $3.46 per person in Nevada. The report notes for the sake of comparison that “median state spending in FY2006-2007 was $786.07 per person annually for K-12 education; $238.05 for higher education; and $104.00 for corrections.”1 The report also notes that federal funding for public health programs is in decline. For example, the report notes that according to current budgetary figures, hospital preparedness grants would be “cut by over $8 million” and “rural health programs would drop by $61 million.”1 In hopes of working toward a determination of the “right amount of public health funding,” TFAH combined its analysis of public health dollars with “key health indicators.” According to the report, “currently, no one knows for sure how much funding the public health system needs.” However, “generating a baseline number for public health spending would allow the government and public to identify areas of the country where spending shortages exist.”1 TFAH concludes that “right now, the health of Americans is being shortchanged due to budget cuts and a misplaced priority for spending on treatments, after people are already sick, rather than spending on prevention. Achieving a healthier America will require a national commitment to invest in and modernize the country’s public health system.” As a first step toward achieving these goals, the report recommends that both federal and state governments institute more “transparent” budget processes which produce “comparable budget information” for public health expenditures.1 References
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