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An Updated Brief Examines State Health Compare Estimates on State Funding for Public HealthAugust 21, 2019:
In light of growing public attention to health care costs and state spending, a number of media outlets have recently published pieces on public health spending per-capita for their state, using the rankings chart provided by SHADAC’s State Health Compare.
SHADAC recently updated our brief on estimates of state-provided funding for the State Health Compare measure “Public Health Funding.” This brief includes state public health funding data from 2013-2017, though data is available on the State Health Compare website starting in 2005 (excepting in 2006, when no data was available).
The Big Picture: Wide Variation between States
There is a wide gap between state public health funding among states, with 2017 state-provided funding ranging from $6 per capita in Missouri to $139 per capita in the District of Columbia. The national average for 2017 was $41 per capita, and the median was $38 per capita.
Top States for State Public Health Funding
Seven states occupied the top five funding spots over the course of five years, from 2013 through 2017 (the most recent five years for which data are available): Alaska, the District of Columbia, Hawaii, Idaho, New York, North Dakota, and West Virginia. Alaska, the District of Columbia, and Hawaii were among the top five states for each of the five years.
Bottom States for State Public Health Funding
Seven states also occupied the bottom five funding spots at various times over the five-year period (2013 through 2017). Arizona, Indiana, Kansas, Mississippi, Missouri, Nevada, North Carolina moved among the bottom five positions for state-provided public health funding during this time period. Arizona, Mississippi, Missouri, and Nevada were among the bottom five each year of this period.
About the Estimates
Estimates of per-capita state funding for public health come from data collected by Trust for America's Health (TFAH), which obtains its calculations using budget documents that are publicly available through state government websites. Depending on which information is available, TFAH uses executive budget documents listing actual expenditures, estimated expenditures, or final appropriates; appropriations bills enacted by the state's legislature; and documents from legislative analysis offices to calculate public health spending. TFAH defines "public health" broadly to include most state-level health funding with the exception of Medicaid, CHIP, or comparable health coverage programs.
Why the Variation among States on this Measure?
According to Trust for America's Health, comparisons of public health funding levels across states are difficult because every state allocates and reports its budget in different ways, and states vary widely in the budget details they provide. Non-methodological sources of inter-state variation in state public health funding may also include the relative performance of individual state economies (since state public health funding is often cut during economic downturns) as well as the relative tax bases of individual states along with state population counts.
Explore Additional Public Health Data at State Health Compare
Visit State Health Compare to explore national and state-level estimates for the following public health indicators:
- Weight Assessment in Schools
- School Nutrition Standards Stronger than USDA
- School Required to Provide Physical Activity
- Smoke Free Campuses
- Cigarette Tax Rates
State Health Compare also features a number of other indicator categories, including: health insurance coverage, cost of care, access to and utilization of care, care quality, health behaviors, health outcomes, and social determinants of health.