Abstract
The United States has a complex governmental public health system. Agencies at the federal, state, and local levels all contribute to the protection and promotion of the population's health. Whether the modern public health system is well situated to deliver essential public health services, however, is an open question. In some part, its readiness relates to how agencies are funded and to what ends. A mix of Federalism, home rule, and happenstance has contributed to a siloed funding system in the United States, whereby health agencies are given particular dollars for particular tasks. Little discretionary funding remains. Furthermore, tracking how much is spent, by whom, and on what is notoriously challenging. This review both outlines the challenges associated with estimating public health spending and explains the known sources of funding that are used to estimate and demonstrate the value of public health spending.
Document Type
Article
Publication Date
4-2018
Digital Object Identifier (DOI)
https://doi.org/10.1146/annurev-publhealth-040617-013455
Funding Information
This work was funded in part by the de Beaumont Foundation.
Repository Citation
Leider, Jonathon P.; Resnick, Beth; Bishai, David; and Scutchfield, F. Douglas, "How Much Do We Spend? Creating Historical Estimates of Public Health Expenditures in the United States at the Federal, State, and Local Levels" (2018). Health Management and Policy Faculty Publications. 11.
https://uknowledge.uky.edu/hsm_facpub/11
Notes/Citation Information
Published in Annual Review of Public Health, v. 39, p. 471-487.
Copyright © 2018 Jonathon P. Leider et al.
This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information.