Looking at US data, Kristian argues that increased public health spending doesn’t always lead to better health outcomes.

The United States (US) has a reputation for disinvesting in public health, with spending from state public health departments dropping by 16% between 2010 and 2020. However, this downward trend seemed to have changed for the better in response to the COVID-19 pandemic. According to data collected by the Centers for Disease Control and Prevention and Trust for America’s Health, the average state spending on public health increased from $91 to $116 (US dollars) per person. A sudden increase in public health spending begs the question: does increased public health spending lead to better health outcomes? And how long would this investment be necessary before outcomes begin improving? By looking at the existing body of data gathered on each states’ per capita investment in public health and their respective health outcomes, we can begin to answer these questions.

The average increase from $91 to $116 may not seem like a significant increase in funding, especially in a country as wealthy as the US. However, given that the US does not have any form of universal healthcare, the sudden increase in public health spending is significant. This average investment per person is even greater in some states. In Alaska for instance, investment in public health increased from $289 in 2020 to a staggering $449 per person in 2021; the largest public health budget in the nation by approximately a $200 margin. 

Investing in public health is a much-needed step in the right direction. However, it must not be forgotten that this increase in investment follows an unparalleled pandemic in the twenty-first century, which highlighted the need for public health spending. Unfortunately, based on information from the same report, it seems that despite the additional investment into public health, many states still suffered notably negative health outcomes such as drug-related deaths (which increased by 4% from 2018 to 2019). 

Although Alaska invested far more money per person than any other state in 2021, it still ranked 27th for overall health outcomes in the US. In part, this is due to a lack of healthcare providers and a high occupational fatality rate in the state. On the other end of the spectrum, Wisconsin, invested the least in public health, at only $72 per person in 2021. We might expect Wisconsin to have significantly poorer health outcomes than other states investing more per capita for the same period. Incidentally, Wisconsin’s health outcomes for 2021 were average, ranking 31st overall in the country. Nevertheless, there does still appear to be a weak correlation between the amount invested per person per state to overall health outcomes. This relationship is exemplified by Hawaii, Vermont, New York, Massachusetts, and Idaho, as all five states placed in the top 10 on both public health spending and health outcome rankings.

By looking at the data we begin to see the effects of continued disinvestment in public health, as well as the effects of sudden reinvestment. Many factors must be considered when assessing the overall health outcomes of a community and they can vary widely from one place to another. However, comparing health outcomes between states opens the door to thinking critically about the successes and shortcomings of a community. As made evident by the relatively lackluster health outcomes in Alaska, despite the state’s massive public health investment per capita, simply throwing money at a problem may not be the best solution. A more tailored approach to public health investment, where the government looks at what is contributing to their negative outcomes and invests heavily into solving those specific problems, would likely be more ideal. In doing so, policymakers can begin to find the “sweet spot” for their own state, which would ideally lead to better health outcomes over the long term. 

Hopefully, the recent uptick in public health investment in the US will not be a one-time event brought on by the COVID-19 pandemic, but a continued push toward improving upon public health shortcomings within each state. If all goes well, community leaders and everyday people will see the impacts of these recent investments. Continued persistence will be key in long-term public health funding, to see a future where health outcomes are improved.