In 2009, the federal government earmarked $13.5 billion in grants to states for public health preparation, an amount virtually unchanged over the last five years, while state and local governments cut their investments in public healthcare by $392 million (3.4 percent). Such a discrepancy means that the federal government needs to step up its public healthcare contributions, concluded a new report from the Robert Wood Johnson Foundation and the Trust for America's Health.
Additionally, federal funding was not equally shared among regions of the United States in 2009. Midwestern states fared the worst with only $16.50 per person, while Northeastern states, among the healthiest populations nationwide, received a comparatively high $19.80 per person. Southern states got $19.75 per person, while Western states netted $19.20.
The discrepancies in federal funding arise from the federal government's failure to coordinate a variety of separately administered programs and focus them based on need, according to Richard Hamburg, Deputy Director of Trust for America's Health. Many programs do not consider population levels, but instead apply a steady level of funding, he explains.
States with influential representation in Congress and voters more concerned about healthcare funding tend to draw larger shares, regardless of the health of their population, Hamburg said.
"It's kind of a chicken and egg question," he said. "Are the states with the most funding healthy because they've traditionally had better public health services, or do healthier states-which typically have more resources-tend to be more aggressive in seeking federal funding?"
Unfortunately, states may trim budgets even further in 2010 because of reduced revenue during the recession. That will curtail public health department services for items such as:
- Chronic disease prevention programs like diabetes and obesity;
- Infectious disease prevention;
- Food and water safety;
- Clean up of the environment; and
- Bioterrorism and health emergency preparedness.