Overview

An article published online on August 12, 2021 on Governing.com entitled, "What Will It Take to Recruit and Retain Public Health Workers?," examines how state spending on key public health activities has been flat or in decline since 2008, and what strategies stakeholders are exploring to meet the need for essential workers. Read the article in full by clicking here.

Overview

S4A investigators based at the Bloomberg School of Public Health publish spending trends in eight categories of public health activity from 2008 through 2018, and find state governmental public health spending saw no statistically significant growth between these years (except in injury prevention). Furthermore, they find state spending levels on public health were not restored after cuts experienced during the Great Recession, which left states inadequately prepared to respond to the pandemic as well as other emerging health needs.

To read "US Public Health Neglected: Flat or Declining Spending Left States Ill Equipped to Respond to COVID-19" in Health Affairs, click here.

doi: 10.1377/hlthaff.2020.01084 HEALTH AFFAIRS 40, NO. 4 (2021)

Overview

S4A investigator David Bishai and team help explain South Korea’s pre-existing capabilities which enabled the rapid and effective implementation of its COVID-19 control strategies, including its health system governance, financing, and regulatory capability honed during the 2015 MERS epidemic.

Read the full article in Health Policy.

https://doi.org/10.1016/j.healthpol.2021.02.011

Overview

New research from Systems for Action investigators at Johns Hopkins University analyzed state government expenditure data collected by the U.S. Census Bureau to estimate U.S. public health spending and found that the official government estimate (Public Health Activity Estimate) is an overestimation of how much is spent on public health. This heightens concerns about spending priorities: the U.S. spends far more on individual medical care than public health programs.

The results of this S4A study can inform decision-making about investments in public health to support COVID-19 response and recovery. Read the one-page report for more key findings and recommended action.

Overview

S4A researchers at Johns Hopkins University take a closer look at governmental expenditure areas in the US and find communities have trended toward more spending on law and order than on health and social services. 

To read the full JPHMP Direct blog post "Following the Great Recession, Governments Spent More on Law and Order and Less on Health and Social Services", click here. 

Overview

S4A investigators at Johns Hopkins University highlight the profound, systems-level issues that constitute the state of rural public health from the 1980s until the present day in the American Journal of Public Health Rural Health.

Read "The State of Rural Public Health: Enduring Needs in a New Decade" here.

Jonathon P. Leider et al. “The State of Rural Public Health: Enduring Needs in a New Decade”, American Journal of Public Health 110, no. 9 (September 1, 2020): pp. 1283-1290. https://doi.org/10.2105/AJPH.2020.305728

Overview

S4A investigator JP Leider, PhD explains how COVID-19 has brought renewed media attention on the issue of underinvestment in public health spending in the United States.

Read Dr. Leider's commentary "Yet Another Post on Public Health Spending" in JPHMP Direct.

Overview

S4A investigators examine the need for improved systems alignment through the lens of Thomas Frieden’s “health impact pyramid, and catalog the types of misalignments and their social, political, and systems genesis. They also identify promising opportunities to realign US health spending toward the socioeconomic factor base of the health impact pyramid and emphasize the need to integrate and align public health, social services, and medical care in the United States.

Read the full article in the American Journal of Public Health's special supplement "Testing New Ways of Connecting the Nation's Fragmented Medical, Social, and Public Health Systems".

J. Mac McCullough, Jonathon P. Leider, Beth Resnick, David Bishai, “Aligning US Spending Priorities Using the Health Impact Pyramid Lens”, American Journal of Public Health 110, no. S2 (July 1, 2020): pp. S181-S185.

Overview

S4A investigators examine the accuracy of official estimates of U.S. governmental health spending by coding administrative spending records from 2000 to 2018 for public health activities according to a standardized Uniform Chart of Accounts.

Read the full article in the American Journal of Public Health's special supplement "Testing New Ways of Connecting the Nation's Fragmented Medical, Social, and Public Health Systems".

Jonathon P. Leider, Beth Resnick, J. Mac McCullough, Y. Natalia Alfonso, and David Bishai, 2020: Inaccuracy of Official Estimates of Public Health Spending in the United States, 2000–2018 American Journal of Public Health 110, S194_S196, https://doi.org/10.2105/AJPH.2020.305709

Overview

The authors of this study reviewed the underlying principles of how public health expenditure estimates are generated. They address what countes as public health spending, who counts it, how it is counted, and why it matters. This article serves as an expansion on previous work on governmental spending estimates through an examination of the methods and implications of national estimates of public health spending.

DISCLAIMER: The authors received financial support from the de Beaumont Foundation supporting this work. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by the de Beaumont Foundation, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.

Overview

An article published in the American Journal of Preventive Medicine entitled, "The Foundational Public Health Services as a Framework for Estimating Spending," discusses estimates of state governmental Foundational Public Health Spending (FPHS) by developing a coding framework to analyze data from the U.S. Census Bureau State Finance hospital expenditure records from 49 states from 2000-2013. To read the article in full, click here. 

DISCLAIMER: The authors received financial support from the de Beaumont Foundation supporting this work. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by the de Beaumont Foundation, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.

Overview

An article published in Public Health Reports entitled, "Machine-Learning Algorithms to Code Public Health Spending Accounts," compares performances of machine-learning algorithms to determine if machines provide a faster, cheaper alternative to manual classification of public health expenditures. Analysis indicates that machine-learning algorithms can be a time and cost-savings tool. To read the article in full, click here. 

DISCLAIMER: The authors received financial support from the de Beaumont Foundation supporting this work. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by the de Beaumont Foundation, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.

Overview

An article published in Health Service Research entitled, "Impact of State Public Health Spending on Disease Incidence in the United States from 1980 to 2009," uses state-level public health spending data from The Census Bureau to better understand the relationship of state-level spending by public health departments and the incidence of vaccine preventable diseases: mumps, pertussis, and rubella. Findings indicate that there is a negative relationship between public health spending and the incidence of vaccine preventable diseases: mumps and rubella. To read the article in full, click here.  

DISCLAIMER: The authors received financial support from the de Beaumont Foundation supporting this work. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by the de Beaumont Foundation, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.

Overview

An article published in Health Affairs entitled,"Government Spending In Health And Nonhealth Sectors Associated With Improvement In County Health Rankings (Related Publications)," uses data from the US Census Bureau to measure the impact of local health outcomes from spending that occurs outside the health care sector (ex: K-12 education, corrections, libraries, housing and community development, etc.). Findings indicate that there are improved health outcomes when county expenditures allocate funding to health and social service areas. To read the article in full, click here. 

DISCLAIMER: The authors received financial support from County Health Rankings and Roadmaps supporting this work. J. Mac McCullough also received funding from the Maricopa County Department of Public Health. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by County Health Rankings and Roadmaps, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.

Overview

An article published in the Journal of Health Care Finance entitled, "Assessing the Public Health Activity Estimate from the National Health Expenditure Accounts: Why Public Health Expenditure Definitions Matter," reports on their project that recodes public health expenditure data from 2000-2013 to create the national Public Health Activity estimate (PHAE). Findings have significant implications for policymakers when considering resource allocation for public health spending. To read the article in full, click here. 

DISCLAIMER: The authors received financial support from the de Beaumont Foundation supporting this work. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by the de Beaumont Foundation, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.

Overview

An article published in the American Journal of Preventative Medicine in 2015 entitled, "Local Fiscal Allocation for Public Health Departments," examines local investment in public health by measuring the percentage of local government taxes allocated to local health departments. Read the article in full by clicking here. 

DISCLAIMER: The authors received financial support from the University of Arizona and JP Leider Research & Consulting, LLC supporting this work. The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review. While this publication was funded by other sources, it is shared on this website because the findings are related to their grant funded by the Robert Wood Johnson Foundation and administered by the Systems for Action National Signature Research Program.