Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts

In this report, the Trust for America’s Health examines public health funding and key health facts in states around the country.

Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts examines public health funding and key health facts for each state, finding:

  • Public Health Emergency Preparedness Cuts: Public Health Emergency Preparedness (PHEP) Cooperative Agreement Funding – which provides support for states and localities to prepare for and respond to all types of disasters – has dropped from a high of $940 million in FY 2002 to $651 million in FY 2016. The Hospital Preparedness Program (HPP) has been cut from a high of $515 million in FY 2004 to $255 million in FY 2016, a cut of more than 50%.
  • National Public Health Funding: Public health spending is still below pre-recession levels.
  • Flat Federal Funding: Federal funding for public health has remained relatively level for years. The budget for CDC has decreased from a high of $7.07 billion in FY 2005 to $6.34 billion in FY 2016, approximately $600 million less than FY 2015 (adjusted for inflation). The amount of federal funding spent to prevent disease and improve health ranged significantly from state to state, with a per capita low of $15.99 in Indiana to a high of $53.06 in Alaska.
  • Cuts in State and Local Funding: 16 states decreased their public health budgets from FY 2013-14 to FY 2014-15. Budgets in six states – Alabama, Indiana, Kansas, North Carolina, Ohio and Oklahoma –decreased for three or more years in a row. In FY 2014-15, the median state funding for public health was $33.50 per person – ranging from a low of $4.10 in Nevada to a high of $220.80 in West Virginia. The median per capita state spending in FY 2015 is around the same rate as in FY 2008 ($33.71), however adjusting for inflation, this represents a cut of $1.2 billion.
  • 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 7.1 percent of adults in Utah have diabetes compared to 14.1 percent in West Virginia, and only 10.3 percent of adults in Utah are current smokers while 27.3 percent of adults report smoking in West Virginia.

Investing recommends that:

  • Core funding for public health – at the federal, state and local levels – be increased;
  • The first dollars of core funding should be used to assure that all Americans are protected by a set of foundational public health capabilities and services no matter where they live. For this to be accomplished, these capabilities must be fully funded, and funding should be tied to achieving and maintaining these capabilities;
  • Funding be considered strategically – so funds are used efficiently to maximize effectiveness in lowering disease rates and improving health;
  • The Prevention Fund should be fully allocated to support evidence-based and innovative approaches to improving the public health system and reducing disease rates;
  • Stable, sufficient, dedicated funding should be provided to support public health emergencies and major disease outbreaks – so the country is not caught unprepared for threats ranging from Ebola to an act of bioterror – and is better equipped to reduce ongoing threats such as the flu, foodborne illnesses and measles. Currently, inadequate and fluctuating resources, along with sequestration and budget caps, have left gaps in the ability to quickly detect, diagnose, treat and contain the spread of illnesses; and
  • Accountability must be at the cornerstone of public health funding. Americans deserve to know how effectively their tax dollars are used, and the government’s use of funds should be transparent and clearly communicated with the public.

And state data pages are available here.