Average State Public Health Spending Per Person, FY 2010-2011*

Public Health Systems—Health and Economics
During crises such as natural disasters or disease outbreaks, the public health system is vital to delivering the health services needed to prevent the spread of illnesses and diseases. In many parts of the country, however, budget challenges and a lack of funding have challenged the ability of the workforce, health departments and data systems to achieve their disease prevention and health promotion goals, including keeping people safe in the event of an emergency.
The United States spends nearly $2.6 trillion on health care each year, but only about 3 percent of it goes to public health. According to an Institute of Medicine report, For the Public’s Health: Investing in a Healthier Future, investing in prevention efforts that reach all people can improve our country’s overall health more efficiently than clinical care alone. The report recommends that a minimum package of public health services be developed for health departments to achieve a more uniform approach to addressing public health challenges effectively.

Public Health Funding
There are no formal guidelines on how to fund public health across federal, state and local levels of government. Financial support for public health varies greatly based on funds received from federal agencies, the health problems and priorities of the area, and state and local appropriations. The recent economic recession has been the single biggest factor affecting public health programs and services, resulting in budget, staff and program cuts that limit health departments’ ability to carry out core functions. According to March 2012 data from the Association of State and Territorial Health Officials and May 2012 data from the National Association of County and City Health Officials:

  • More than 52,200 state and local jobs have been lost since 2008, representing a loss of 17 percent of the state and territorial public health workforce and a loss of 22 percent of the local public health workforce.
  • Since 2009, around 50 percent of local health departments have had to cut at least one program.

How Are States Responding to Cuts?
State policymakers have found ways to leverage funds and resources between local and state health departments and improve efficiencies. For example, some states are using community health assessments to target programs and resources, sharing certain services among local and state health departments, coordinating care among clinical providers and public health agencies, and seeking accreditation to improve overall performance and services.

Sources: CDC; IOM; ASTHO; NACCHO; NCSL staff research; Trust for America’s Health.

Average State Public Health Spending Per Person, FY 2010-2011*

United States map of Average State Public Health Spending Per Person, FY 2010-2011

* Notes: The map reflects states' investments (i.e., does not include federal investments provided to and distributed by states) for public health. Spending may contain some social service programs, but not Medicaid or CHIP. General funds only and budget data taken from appropriations legislation. State and local funding varies based on a state's public health structure and its health priorities.

Source: Trust for America's Health, Investing In America's Health: A State-By-State Look At Public Health Funding and Key Health Facts, March 2012; http://healthyamericans.org/report/94/.

This postcard was supported in part by the Cooperative Agreement 1U38OT000110-01 from the Centers for Disease Control and Prevention. It's contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.