Spending by non-governmental public health providers

Public health is not done exclusively through government agencies. Primary care may be performed by hospital clinics, smoking cessation sponsored by religious institutions, or health education provided by senior centers. Although such activities are not included in traditional counts of public health services or spending, the impact may be just as strong.

This study uses a recently completed survey in New Hampshire. In addition to quantifying state and local agency spending, over 50 non-governmental providers were included. This data is linked to demographics, community health status indicators, and NACCHO profile data.

We analyze the association between spending by non-government service providers and other factors. Possible determinants include population, poverty, income inequality, age, state spending, local spending, smoking and other health indicators. A funding formula analysis tool is also employed to measure the impact of non-government spending on conventional sources. For example, do such organizations bend overall total spending more towards per capita equity?

We found that non-governmental spending is strongly and positively associated with population. Non-government public health spending is also positively associated with state funding, but not with local spending. There are strong indications that associations are stronger at the regional level than at the township level.

These non-government sources provide public health services at their own discretion, but their help nonetheless promotes the general good. This project builds a better understanding of these non-government providers, providing an important first step towards building partnerships and perhaps cultivating additional help.