Policymakers took heart from聽another year of聽relatively slow聽health-spending growth聽in 2011, documented by government statisticians聽and Monday. But one aspect of moderating health expenditures — and the only category showing聽outright decline — could cost more than it saves. Hit by recession and tight budgets, spending on public health by federal, state and local governments fell聽in 2011 for the first time since analysts started tracking the numbers in 1960.
“Public health is adaptable, but the resource reductions now have been so substantial that it truly does put the public’s health at risk,” said Dr. Georges C. Benjamin, executive director of the American Public Health Association, an organization of public health pros. “I’m usually a little reluctant to say that, but we’re at that point.”
Research links higher public health spending with聽reduced rates of infant mortality, preventable deaths in adults and other measures of community health.
“We’ve got strong evidence there is a connection between聽resources invested in public health and health outcomes,” said Glen P. Mays, a professor at the University of Kentucky whose associated a 10 percent increase in local public health spending over more than a decade聽with reductions in death rates of between 1 percent and 7 percent. “That suggests that cutbacks in funding,聽certainly over time, could have some adverse health consequences.”
One factor depressing聽public-health outlays in 2011 was the expiration of , which caused a 2009 pandemic,聽said Micah Hartman, an HHS statistician.聽But聽public health spending has slowed聽in other areas,聽a trend advocates say hurts efforts to聽fight聽disease, prepare for emergencies and ensure safe food and water supplies.
Total public health expenditures聽fell by 0.5 percent in 2011 to $79 billion. That’s down from聽growth of 4.9 percent in 2010 and 6.9 percent in 2007.聽Those聽government-wide results聽include sharp聽deterioration of state and local public health budgets.聽Since 2008 state and local public health departments have cut about 50,000 jobs, the American College of Physicians.
Anemic聽public health budgets jeopardize emergency preparedness聽progress made聽after聽Hurricane Katrina and the Sept. 11, 2001, terrorist attacks, according to a聽 from the Trust for America’s Health and the Robert聽Wood Johnson Foundation. Twenty-nine states cut public health funding last fiscal year; for 14 of them it was the third consecutive year of tightening,聽the report said.
Benjamin pointed to the current whooping cough outbreak, since the 1950s, as a threat that needs to be faced with more firepower. “A shortage of funding didn’t cause the outbreak,” he said. “But the public health professionals that are dealing with the outbreak will tell you that their response has not been adequate because of the resource problems.”
