The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71620

Glen P. Mays, PhD, MPH¹, Megan C. McHugh, MPP¹, Kyumin Shim, PhD², Natalie Perry, DrPH², Paul Halverson, DrPH³, Dennis D Lenaway, MPH, PhD², Sergey Sotnikov, PhD², and Ramal Moonesinghe². (1) Mathematica Policy Research, 600 Maryland Avenue SW, Suite 550, Washington, DC 20024, 202-484-4236, gmays@mathematica-mpr.com, (2) Division of Public Health Systems Development and Research, Public Health Practice Program Office, Centers for Disease Control and Prevention, 2877 Brandywine Road, MS K-39, Atlanta, GA 30341, (3) Public Health Practice Program Office, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-39, Atlanta, GA 30341-3724

OBJECTIVES: The confluence of new federal spending on bioterrorism preparedness, the recent economic downturn, and large deficits in state and local government budgets has refocused attention on the critical policy question of how to make optimal investments in public health infrastructure. This study examines how local public health spending levels and funding sources influence the performance of essential public health services within communities. METHODS: We use data from local public health systems in seven states that participated in the National Public Health Performance Standards Program pilot tests between 1999 and 2001 (n=315). We link NPHPSP performance measures with secondary data on local public health spending, federal public health funding levels, and community resources. Multivariate econometric models are used to estimate the effects of local spending and federal funding sources on public health performance while controlling for other institutional and community characteristics. KEY FINDINGS: Multivariate estimates demonstrate that both the scope of services performed and the overall level of performance achieved is significantly higher in communities with greater spending per capita and larger amounts of direct federal funding, even after controlling for other community characteristics. Results indicate which essential services are likely to be most affected by recession-related reductions in local public health spending, and which services are likely to benefit most from direct federal support. CONCLUSIONS: These findings can assist public health decision-makers in identifying public health financing priorities during periods of change in the resources available to support local public health infrastructure.

Learning Objectives:

Attendees will be able to (
• understand the current policy and budgetary pressures that are shaping financing decisions for local public health infrastructure; (
• identify how local public health spending levels and funding sources affect the performance of essential public health services in local communities; and (
• develop strategies for achieving improvements in public health system performance through targeted public financing efforts.

Keywords: Economic Analysis, Public Health Administration

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.