Resources that May Matter

The Impact of Local Health Department Expenditures on Health Status

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.

April Issue of Health Affairs Focuses on Patient Safety and Health Care Quality

  1. 1. The Ongoing Quality Improvement Journey
  2. 2. A Road Map for Improving the Performance of Performance Measures
  3. 3. The Trade-Off Among Quality, Quantity, and Cost
  4. 4. Global Trigger Tool' Shows that Adverse Events in Hospitals May be Ten Times Greater Than Previously Measured
  5. 5. Preventing Bloodstream Infections
  6. 6. Measuring the Performance of Individual Physicians by Collecting Data from Multiple Health Plans
  7. 7. Measuring Health Care Performance Now, Not Tomorrow
  8. 8. Despite Improved Quality of Care in the Veterans Affairs Health System, Racial Disparity Persists for Important Clinical Outcomes
  9. 9. The Importance of Transitional Care in Achieving Health Reform
  10. 10. An Early Status Report on the Beacon Communities' Plans for Transformation Via Health Information Technology
  11. 11. A Comparative Study of 11 Local Health Department Organizational Networks
  12. 12. Public Health Performance
  13. 13. A Self-Assessment Process for Accreditation Preparedness
  14. 14. Public Health Delivery Systems
  15. 15. Regionalization in Local Public Health Systems
  16. 16. Public Health Services and Systems Research
  17. 17. A Shot in the Rear, Not a Shot in the Dark
  18. 18. What Predicts Local Public Health Agency Performance Improvement?
  19. 19. Growth of a Scientific Community of Practice
  20. 20. Evolution of Coauthorship in Public Health Services and Systems Research
  21. 21. Resources that May Matter
  22. 22. Evidence Links Increases in Public Health Spending to Declines in Preventable Deaths
  23. 23. Public Health Financial Management Competencies
  24. 24. Decision Science
  25. 25. Public Health Financial Management Needs
  26. 26. Data-Driven Management Strategies in Public Health Collaboratives
  27. 27. Using Geographic Information Systems to Match Local Health Needs with Public Health Services and Programs
  28. 28. Public Health Systems and Services Research
  29. 29. Local Public Health Capacities to Address the Needs of Culturally and Linguistically Diverse Populations
  30. 30. A Needs Assessment for Data and Methods in Public Health Systems Research
  31. 31. Mapping the Multidisciplinary Field of Public Health Services and Systems Research