Disparities by State in Public Health Indicators, Funding Persist

Key indicators of public health as well as budgets for preventing disease and improving community health vary widely by state, a new report from Trust for America's Health and the Robert Wood Johnson Foundation finds.

The ninth in a series, the report, Investing in America's Health: A State-by-State Look at Public Health Funding and Key Health Facts 2014 (36 pages, PDF), found that state funding for public health fell in fiscal year 2012-13 in thirty-three states and Washington, D.C., was cut for two or more years in a row in twenty states, and declined for three or more consecutive years in sixteen states. The report also found that between FY2008 and FY2013, the median per capita state spending on public health fell from $33.71 to $27.49, ranging from a high of $144.99 in Hawaii to a low of $5.86 in Missouri. Federal funding for public health has remained flat for years, with spending per capita by the Centers for Disease Control and Prevention averaging $18.92 in 2013.

The report also identified significant disparities at the state level in various indicators, including rates of uninsured adults, ranging from 4.1 percent (Massachusetts) to 24.6 percent (Texas); diabetes, ranging from 7 percent (Alaska) to 13 percent (West Virginia); and smoking, ranging from 10.6 percent (Utah) to 28.3 percent (Kentucky). Disparities in health indicators for children include rates of asthma among high school students, ranging from 16 percent in Iowa to 28.7 percent in Maryland, and obesity rates among 10- to 17-year-olds, ranging from 9.9 percent in Oregon to 21.7 percent in Mississippi.

In addition to calling for more funding for core public health programs, the report recommends taking a more strategic approach to funding the national public health system; targeting Prevention Fund investments not only to reduce rates of chronic disease but also to modernize the approach to public health; strengthening accountability; and bolstering the public health capabilities and services across all states.