PNHP

Declines in preventable deaths linked to increases in public health spending

Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths

By Glen P. Mays, and Sharla A. Smith
Health Affairs, July 21, 2011

Public health activities in the United States are supported through a patchwork of funding sources and financing arrangements that vary widely across states and communities and that are relatively unstable over time. These arrangements result in large geographic differences in spending for public health activities, even among communities with relatively similar population characteristics and health needs.

At the state level, per capita public health spending varied by a factor of more than thirty in 2010, ranging from a low of less than $4 in Nevada to a high of more than $171 in Hawaii. Local variation in public health spending was even larger, ranging from less than $1 per capita to more than $200 per capita in 2008.

Communities with larger increases in public health spending experienced larger reductions in mortality from leading preventable causes of death over a thirteen-year period. This relationship was consistent across several different mortality measures, and it persisted after accounting for differences in demographic and socioeconomic characteristics, medical resources, and unobserved community characteristics that jointly influence spending and health.

Although our study does not establish a definitive causal link between spending and mortality because of the observational research design we used, it nevertheless provides compelling evidence that differences in public health investments may contribute to differences in community health outcomes.

http://content.healthaffairs.org/content/early/2011/07/19/hlthaff.2011.0196.abstract

Comment: 

By Don McCanne, MD

This study is just a reminder that population health involves much more than just the interaction between patients and their health care professionals and institutions. The importance of the public role is undeniable. It’s too bad that our politicians don’t seem to understand that.

Declines in preventable deaths linked to increases in public health spending

Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths

By Glen P. Mays, and Sharla A. Smith
Health Affairs, July 21, 2011

Public health activities in the United States are supported through a patchwork of funding sources and financing arrangements that vary widely across states and communities and that are relatively unstable over time. These arrangements result in large geographic differences in spending for public health activities, even among communities with relatively similar population characteristics and health needs.

At the state level, per capita public health spending varied by a factor of more than thirty in 2010, ranging from a low of less than $4 in Nevada to a high of more than $171 in Hawaii. Local variation in public health spending was even larger, ranging from less than $1 per capita to more than $200 per capita in 2008.

Communities with larger increases in public health spending experienced larger reductions in mortality from leading preventable causes of death over a thirteen-year period. This relationship was consistent across several different mortality measures, and it persisted after accounting for differences in demographic and socioeconomic characteristics, medical resources, and unobserved community characteristics that jointly influence spending and health.

Although our study does not establish a definitive causal link between spending and mortality because of the observational research design we used, it nevertheless provides compelling evidence that differences in public health investments may contribute to differences in community health outcomes.

http://content.healthaffairs.org/content/early/2011/07/19/hlthaff.2011.0196.abstract

This study is just a reminder that population health involves much more than just the interaction between patients and their health care professionals and institutions. The importance of the public role is undeniable. It’s too bad that our politicians don’t seem to understand that.