Report: U.S. lacks funding to improve public health

April 8, 2013

The Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation have released a new report examining public health funding and key health facts in states in the U.S. “Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts” states that the country has been focused on treating people after they become sick instead of preventing diseases before they occur. Investing in disease prevention is the most effective, common-sense way to improve health—helping to spare millions of Americans from developing preventable illnesses, reduce healthcare costs, and improve the productivity of the American workforce.

The report’s findings include:

  • Inadequate Federal Funding: Federal funding for public health has remained at a relatively flat and insufficient level for years. The budget for U.S. Centers for Disease Control and Prevention (CDC) has decreased from a high of $7.31 billion in 2005 to $6.13 billion in 2012. Spending through CDC averaged only $19.54 per person in FY 2012. And the amount of federal funding spent to prevent disease and improve health in communities ranged significantly from state to state, with a per capita low of $13.72 in Indiana to a high of $53.07 in Alaska.
  • Cuts in State and Local Funding: At the state and local levels, public health budgets have been cut at drastic rates in recent years. According to a TFAH analysis, 29 states decreased their public health budgets from FY 2010–11 to FY 2011–12. Budgets in 23 states decreased for two or more years in a row, and budgets in 14 states decreased for three or more years in a row. In FY 2011–12, the median state funding for public health was $27.40 per capita, ranging from a high of $154.99 in Hawaii to a low of $3.28 in Nevada. From FY 2008 to FY 2012, the median per capita state spending decreased from $33.71 to $27.40. This represents a cut of more than $1.15 billion, based on the total states’ budgets from those years, which would be $1.9 billion adjusted for inflation.
  • Wide Variation in Health Statistics by State: There are major differences in disease rates and other health factors in states around the country. For instance, only 6.7% of adults in Colorado and Utah have diabetes compared to 12.3% in Mississippi, and less than 12% of adults in Utah are current smokers while almost 30% report smoking in Kentucky.

Overall, the report concludes that a sustained and sufficient level of investment in prevention is essential to improving health in the United States, and that differences in disease rates will not be changed unless an adequate level of funding is provided to support public health departments and disease prevention efforts.