At the same time, the Federal government cut $8 million from CDC’s funds for chronic disease prevention and health promotion.
And in our post-Katrina, post-9/11 world, Congress and the Bush Administration cut CDC’s program for upgrading state and local emergency preparedness capacity by $56 million — a nearly 7% drop in funding.
What’s wrong with this picture?
It’s called Shortchanging America’s Health, as portrayed in the new report of the same name from the Trust for America’s Health (TFAH). The Robert Wood Johnson Foundation (RWJF) funded the study. TFAH is a non-profit, non-partisan organization that’s made disease prevention Job #1. The Trust boasts a star-studded Board all of whom have worked hands-on with the broad-range of public health challenges in their careers.
The topline: we’re spending too much on sick care rather than on prevention and true health care. As the introduction to the report states, “Right now, the health of Americans is being shortchanged due to budget cuts and a misplaced priority for spending on treatments, after people are already sick, rather than spending on prevention.”
The Federal government has obligations to each of the 50 states for public health. They are to:
- Assure capacity for essential public health services
- Act when health threats span impact states and regions
- Act where a health challenge is beyond the jurisdiction of a state
- Act to assist states when they do not have expertise or resources to mount an effective response in a public health emergency such as a natural disaster (that would be, say, a Katrina scenario), bioterrorism, or an emerging disease.
The absolute dollar decline in public health spending puts these obligations at risk.The median state spending on public health is $33.26 per person, with a range of $3.46 per person in Nevada to $152.66 per person in Hawaii.
The study found sharp differences in the funding levels for public health across regions of the U.S. The average per capita CDC spending is lowest in the Midwest, which received an average of $16.24 per person. The highest funding is in the South, at $29.40, nearly double the amount of per capita CDC spending found in the Midwest. Western states come in second-lowest at $19.74. The Northeastern states are funded at $23.37 per person.
State-by-state funding is even more varied. Alaska receives more than any other state, at $69.76 per person. Kansas receives the least, at $13.61 per person.
CDC funding goes for a variety of public health initiatives, including cancer prevention, chronic disease prevention and health promotion, diabetes control, environmental health, HIV prevention, immunizations, infectious disease prevention, and bioterrorism preparedness.
Health Populi’s Hot Points: So many of us have been pointing out declines in public health and prevention spending for several years. It’s such a no-brainer issue with a real, hard ROI in so many ways: both macroeconomic (in terms of productivity and tax revenue potential) and microeconomic (with respect to quality of life in the household, kids’ days in school, etc.). Yet, deaf ears and lack of political prioritization rule the day in Congress and within the Bush Administration. Let’s make the November 2008 election a re-commitment to the public’s health. That would include your health, my friends.