Midwestern and Southern States Receive Least Federal Funding for Disease Prevention

New report finds public health programs at risk during economic downturn.

    • March 10, 2009

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) today released a new report that found Midwestern and Southern states received less funding from the federal government than Northeastern and Western states did in fiscal year (FY) 2008 for disease prevention programs, which can amount to millions of dollars in differences. Shortchanging America’s Health: A State-By-State Look at How Federal Public Health Dollars are Spent also examines how the economic downturn could lead to serious cuts to disease prevention and emergency preparedness programs at the state level.

The report found that states receive $17.60 per person on average from the U.S. Centers for Disease Control and Prevention (CDC) to spend on public health.  Midwestern states received an average of $15.40 per person and Southern states received $17.89 per person, while Northeastern states received $18.99 and Western states received $18.15 per person from the CDC.

“Even in better economic times, the country’s investment in keeping the public healthy and safe is a tiny fraction of what we spend on treating people after they’ve become sick.  Our priorities are upside down.  And now in tough times, this balance could get worse, but we shouldn’t forget that cutting public health programs to try to solve short-term budget problems will result in long-term negative financial and health consequences,” said Jeff Levi, PhD, Executive Director of TFAH.  “Public health programs help keep disease rates down, which in turn keeps health care costs down.  It’s going to be hard to get the economy healthy again if our workers and our health care system are both sick.”

Alaska received the most funding from CDC of any state at $52.78 per person in FY 2008, while Indiana received the least at $12.74 -- a $40 difference.  Approximately 75 percent of CDC’s budget is distributed through grants or cooperative agreements to states and communities to support programs to prevent diseases and prepare for health disasters.

Public health programs are supported through a combination of federal, state, and local resources.  State funding is expected to drop significantly as state governments face severe budget crises.  According to the Center on Budget and Policy Priorities (CBPP), at least 46 states are facing shortfalls to their 2009 and/or 2010 budgets.  CBPP estimates that combined budget gaps for states in the remainder of 2009, 2010, and 2011 could total more than $350 billion. 

Some health programs at-risk for cuts include:

  • Cancer, diabetes, obesity, and other chronic disease prevention;
  • HIV/AIDS, MRSA, TB, and other infectious disease prevention;
  • Food and water safety;
  • Environmental health improvement; and
  • Bioterrorism and health emergency preparedness.

In addition, more than 11,000 state and local public health jobs have already been cut, and another 10,000 may be cut, according to surveys conducted by state and local health departments.

The American Recovery and Reinvestment Act provided an additional $1 billion for public health programs for next year, which will help provide additional support in many communities. 

“The financial crisis makes it more important than ever for the country to make prevention a top priority,” said Risa Lavizzo-Mourey, M.D., M.B.A president and CEO of the Robert Wood Johnson Foundation.  “Even in these troubled times, prevention is an investment we can count on to deliver a big payoff—sparing millions of people from developing preventable diseases while saving billions in health care costs.”

The full report includes state-by-state pages of key health statistics and funding information and is available on TFAH’s Web site at www.healthyamericans.org. The report was supported by a grant from RWJF.

Rankings of CDC Funds for States (Based on Fiscal Year 2008)

1=Most funds; 50=Least funds. Funds are listed on a per person basis. The national average CDC funding is $17.60 per person.

1. Alaska ($52.78); 2. Vermont ($35.15); 3. Wyoming ($32.43); 4. Rhode Island ($32.09); 5. New Mexico ($30.94); 6. South Dakota ($29.12); 7. North Dakota ($27.45); 8. Hawaii ($25.55); 9. Delaware ($24.98); 10. Montana ($24.33); 11. Maine ($23.53); 12. Maryland ($22.92);  13. West Virginia ($21.78); 14. New York ($21.39); 15. Washington ($21.34); 16. Louisiana ($21.25); 17. New Hampshire ($21.07); 18. Idaho ($20.97); 19. Massachusetts ($20.85); 20. Nebraska ($20.54); 21. Mississippi ($20.04); 22. Nevada ($19.67); 23. Arkansas ($19.19); 24. Oklahoma ($19.10); 25. North Carolina ($19.00); 26. South Carolina ($18.69); 27. Georgia ($18.68); 28. Connecticut ($18.63); 29. Colorado ($17.92); 30. Arizona ($17.30); 31. Texas ($17.16); 32. Alabama ($16.95); 33. Illinois ($16.66); 34. Iowa ($16.37); 35. Oregon ($16.33); 36. California ($15.94); 37. Michigan ($15.76); 38. New Jersey ($15.75); 39. Utah ($15.73); 40. Minnesota ($15.66); 41. Kansas ($15.14); 41. Missouri ($15.14); 43. Wisconsin ($14.97); 44. Tennessee ($14.96); 45. Pennsylvania ($13.99); 46. Kentucky ($13.94); 47. Florida ($13.29); 48. Virginia ($12.88); 49. Ohio ($12.76); 50. Indiana ($12.74).

* Regions are based on the U.S. Census Bureau definitions. Midwestern states include: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. Northeastern states include: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. Western states include: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. Southern states include: Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. Washington, D.C., is included in the national and regional (in the Southern region) analyses.

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to improving the quality of the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful, and timely change. For more than 35 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.

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