Consequences of public health budgets cuts

The economic recession that started in 2007 has been associated with reductions in government spending. Our study focuses on changes to public health funding since 2007, helping practitioners and policy makers minimize adverse health consequences.

Our study starts with a measure of change in local health department (LHD) budgets and expenditures between 2008 and 2010. These figures are retrieved from the National Profile of Local Health Departments (2008 and 2010) compiled by the National Association of County and City Health Officials. This information is linked to US Census demographic and economic variables, such as poverty, race, employment, and language spoken. We also compute changes in key measures of public health over the same time using Community Health Status Indicators.

Using multivariate regression, we estimate the impact of budget changes on public health outcomes, adjusting for socio-economic characteristics and health department structure. In this way, we isolate key factors that moderate the effects of changes to budgets.

Preliminary findings reveal that LHDs drawing a larger share of funds from local sources were in better shape to weather the budget cuts. Their budget reductions tended to be smaller, and their outcomes showed less decline. Areas that show the sharpest declines tended to be poor and rural.

Our findings will help policy makers and administrators understand the impact of budget cuts in terms of the effect on vulnerable populations and the possible changes in health status indicators.