Online Program

How much do state health agencies spend on non-public health activities?

Tuesday, November 5, 2013 : 8:30 a.m. - 8:50 a.m.

JP Leider, PhD, de Beaumont Foundation, Bethesda, MD
State health agencies are central to the public health enterprise. They are guarantors of communicable disease control, enforcers of laws and regulations, and are responsible for the current and future health of the residents of their state. However, many state health agencies provided programs and services that are beyond the scope of traditional public health. Current measures of state spending on public health, namely through the endeavors of the Association of State and Territorial Health Officials, tend to exclude non-public health spending. As such, these estimates have not previously been available to practitioners or researchers. To better understand the current state of state health agencies, we have analyzed administrative budget data available through the Census' State Finance division, and have parsed public health spending from total spending in the designated state health agencies. For FY11, over 186,000 budget line items constituted the spending dataset for designated state health agencies. Preliminary analysis suggests that 62% of the $16.7 billion spent by free-standing agencies went toward public health and behavioral health provision, while 26% went to payments to vendors for clinical care, and 5% went toward transfer to local government. Among umbrella agencies (where public health may be one division among several), approximately $77.4 billion was spent in FY11, 70% went to payments to vendors for clinical care, 10.6% went for public health and behavioral health, 4.7% went toward welfare, and 9% went toward local transfers of any kind. The data show that state health agencies are responsible for several facets affecting population health and well-being, beyond public health. This suggests a greater need to understand how public health relates to other governmental agencies, bureaus, and departments when running financial analyses and when conducting public health planning.

Learning Areas:

Administration, management, leadership
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe how much state health agencies spend on activities that are not characterized as traditional public health

Keyword(s): Financing, Health Departments

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: JP Leider has experience as a Research Assistant at the Berman Institute. He is a doctoral fellow with the Office of Public Health Training & Practice, and consults with the Office of Population Health Improvement at the Maryland Department of Health. For his dissertation, JP is examining the budget and priority setting processes at state public health agencies.I conceptualized and conducted data analysis for this work, am trained in empirical methods.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.