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Public Health Spending Declined Ahead of Pandemic

Analysis  |  By Jack O'Brien  
   March 26, 2021

The study also indicated that state public health spending levels were not restored after cuts made during the Great Recession.

U.S. public health spending fell in the decade preceding the COVID-19 pandemic, according to a Health Affairs study released Thursday afternoon.

While national health expenditures grew 4.3% between 2008 to 2018, researchers found "no statistically significant growth" in state public health spending beyond injury prevention. State public health spending fell from $80.40 per capita in 2008 to $75.83 in 2018.

Among the public health activities that experienced flat or downward trends were "maternal, child, and family health; chronic disease prevention; and access and linage to critical care."

Related: U.S. Healthcare Spending Grew 4.6% in 2019, Hit $3.8T

Flat public health spending was also associated with declines in life expectancy and rising mortality rates, especially among White Americans between the ages of 45 and 65.

The research was released just over a year after the start of the domestic spread of COVID-19, which has killed more than 500,000 Americans.

Government data released last month found that the U.S. life expectancy declined by one year during the first half of 2020. 

Related: Modifiable Health Risks Add $730B to U.S. Healthcare Spending

The study also indicated that state public health spending levels were not restored after cuts made during the Great Recession, a dynamic that left states "ill equipped to respond to COVID-19 and other emerging health needs."

“Since stagnant public health spending was seen in almost all states during the period studied, this indicates widespread neglect across the spectrum rather than neglect associated with a particular political ideology or regional geography,” the authors concluded. “There are likely to be immediate short-term increases in public health spending to support COVID-19 responses by state and federal government. . .Without institutional reform, states are susceptible to continued neglect of public health with only short-term emergency infusions of federal funding in the midst of a crisis such as COVID-19.”

Related: The Questionable Line Items of Illinois' COVID-19 Spending

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

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