Previously, little research has been done in the area of the impact of public health spending on population health. Mays and Smith analyzed changes in spending patterns and mortality rates within the service areas of the nation's nearly 3,000 local public health agencies over a 13-year period.
Increases in public health spending were associated most significantly with reductions in deaths for four of the six mortality rates, with the strongest effects for infant mortality and cardiovascular disease mortality.
After accounting for differences in demographic and socioeconomic characteristics, medical resources and other factors, communities that made the largest investments in public health spending experienced the most significant reductions in mortality from leading preventable causes of death.
"Although a definitive causal link between spending and mortality cannot be drawn, the study does provide compelling evidence that communities must pay attention to more than local medical resources and interventions, but also to the resources invested in local public health activities to truly make a difference in the health of their people," Mays said.
Public health spending varies widely around the country. For example, per capita state public health spending ranged from a low of less than $4 in Nevada to a high of more than $171 in Hawaii. Local public health spending varied even more significantly ranging from less than $1 per capita to more than $200 per capita, with the median spent around $36 per person.
The study provides a foundation for further research, particularly in light of the ACA investment of a projected $15 billion in new spending over 10 years in federal public health spending and the continued reductions in state and local government spending for public health, Mays said.
|Contact: Ann Blackford|
University of Kentucky