How Public Health Spending Affects Community Health

One of the headlines this morning is the Mississippi State Department of Health asking the legislature for over $100 million of the $1.8 billion in American Rescue Plan Act money allocated to the state. The federal pandemic relief money would be in addition to the department's annual budget request.?

Public health programs and services have been chronically underfunded at the federal, state, and local levels for decades. The COVID-19 pandemic made the failure to invest in programs combatting these public health challenges glaringly clear. There is a lack of funding for all state health departments nationwide – but individual state departments are even funded at different per capita levels. Mississippi spends $16 per capita – much less than any of our sister states – as shown in the graph above.

Just like individual health, population health is substantially determined by community-based issues that fall outside the purview of basic clinical care.?In new population health models, hospitals must work hand in hand with public health entities to affect social determinants of health in their communities. When either group is underfunded, community health will suffer.

The southeastern region of the United States, which includes Mississippi, has the lowest percentage of adults with a college degree, the highest poverty rates, and the highest unemployment rates. Mississippi is the poorest state in the nation – so we have the most social needs to address in our region with the least dollars invested.?We have much work to do and limited funds to get any work done.

In 2006, the Institute for Healthcare Improvement (IHI) developed a framework to describe an optimal health care system. This framework, named the Triple Aim, has three dimensions: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care. Improving the health of populations is the purview of public health. Every dollar matters.?