In communities that saw a fall in death and disease from 1993 to 2005, public health funding had been increased.

When they are larger in size and budget, local health departments (LHDs) perform better. Longitudinal studies have provided a clear picture of how fluctuations in LHD funding affect mortality and morbidity in the communities served by the LHDs. This study employed a longer study time period and more robust statistical controls than were previously available in the relevant literature.

This research article presents a retrospective cohort study that examined how changes in state-level LHD funding impacted smoking, infant mortality, cardiovascular disease and cancer deaths, and overall premature death (public health interventions have been shown to have an effect on the chosen measures). The authors created their model to reflect ongoing, real events: (1) the steady reduction in federal funding; (2) the economic crisis; (3) the bypassing of the public health system in the allocation of resources under the Patient Protection and Affordable Care Act (PPACA); and (4) comparative effectiveness research. Researchers derived their data from the National Association of County and City Health Officials (NACCHO) surveys for 1993, 1997 and 2005.

Key Findings:

• From 1993 to 2005, in communities where LHD funding increased, people lived longer.
• For each $10 increase in LHD spending there was a 7 percent decrease in deaths from infectious disease.

This study examined data from 1993 to 2005. Statistical analyses showed that when LHDs receive greater resources, there is a drop in community disease and death. In light of the overwhelming cost burden of diseases like HIV, the findings presented here represent a major opportunity to reduce health expenditures.