Skip to main content

Main Area

Main

How much every state spends on public health

  • How much every state spends on public health

    Public health is the branch of medicine that deals with prolonging and improving the quality of life across entire populations. That might include public education campaigns; hygiene mandates; disease-prevention initiatives; the promotion of healthy communities, households, and individuals; plans of action for emergency preparedness and response; anti-addiction or non-smoking initiatives; and even programs that deal with things like violent crime and racism.

    In America, the states are responsible for creating, administering, funding, and overseeing public health policies, services, initiatives, and governing bodies—but not all states put an equal amount of resources into the cause.

    To examine how much every state spends on public health, Stacker consulted a Kaiser Health News and Associated Press analysis conducted in summer 2020, in conjunction with the Kaiser Health News "Underfunded And Under Threat" series. State- and county-level spending data are from the U.S. Census Bureau Annual Survey of State and Local Government Finances and the State Health Expenditure Dataset and are up to date as of 2017. State public health agency spending data are from the Association of State and Territorial Health Officials and are up to date as of 2018. Ranks included in the story are based on per capita spending figures. All figures in the story are adjusted to 2019 dollars.

    The COVID-19 crisis has forced many states to reexamine their public health budgets or even the framework of their entire public health infrastructure. In other states, years of cuts to public health budgets came home to roost when the pandemic revealed gaping inadequacies in equipment, staff, facilities, and strategic plans of action.

    Keep reading to learn which states spend the most on public health, in order from the lowest spenders to the biggest, plus what they're doing right, what they're doing wrong, the challenges they're facing, and the opportunities they're seizing during an unprecedented health care crisis.

    You may also like: Racial breakdown of COVID-19 cases in every state

  • #51. Arizona

    - Total state public health spending (2017): $532.1 million ($76 per capita)
    --- Hospital spending (2017): $5.0 million ($1 per capita, #1 lowest among all states)
    --- Non-hospital spending (2017): $527.1 million ($75 per capita, #6 lowest)
    --- Public health agency spending (2018): $576.3 million ($79 per capita, 16.4% up from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Navajo County ($156.7 million total, $1,437 per capita)
    --- #2. Greenlee County ($2.1 million total, $226 per capita)
    --- #3. Maricopa County ($757.0 million total, $175 per capita)

    According to the Arizona Republic, some experts argue that the state's paltry per capita health care spending actually represents a commitment to building for the future. Some of that funding, experts tell the paper, goes to investments in future infrastructure, disease-protection efforts, and the mitigation of health disparities.

  • #50. Indiana

    - Total state public health spending (2017): $731.0 million ($110 per capita)
    --- Hospital spending (2017): $149.1 million ($22 per capita, #3 lowest among all states)
    --- Non-hospital spending (2017): $581.8 million ($87 per capita, #10 lowest)
    --- Public health agency spending (2018): $405.6 million ($59 per capita, 5.7% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Knox County ($225.4 million total, $6,084 per capita)
    --- #2. Bartholomew County ($397.8 million total, $4,839 per capita)
    --- #3. Dubois County ($200.4 million total, $4,711 per capita)

    According to an annual report from the United Health Foundations (UHF), Indiana benefits from low instances of excessive drinking among its population but suffers from a high prevalence of smoking. There are only small differences in health disparity by high school education, but immunization rates among children are low, and there aren't enough mental health providers in the state.

  • #49. Idaho

    - Total state public health spending (2017): $210.2 million ($122 per capita)
    --- Hospital spending (2017): $55.4 million ($32 per capita, #5 lowest among all states)
    --- Non-hospital spending (2017): $154.8 million ($90 per capita, #11 lowest)
    --- Public health agency spending (2018): $102.0 million ($57 per capita, 3.0% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Kootenai County ($468.3 million total, $2,977 per capita)
    --- #2. Butte County ($6.5 million total, $2,509 per capita)
    --- #3. Benewah County ($21.9 million total, $2,390 per capita)

    The Get Healthy Idaho program represents a "major shift in the way Idaho funds and addresses population-level prevention and health promotion strategies," according to the program's website. The initiative is currently working to create a five-year plan to identify and address the state's most pressing health priorities.

  • #48. New Hampshire

    - Total state public health spending (2017): $168.8 million ($125 per capita)
    --- Hospital spending (2017): $65.2 million ($48 per capita, #8 lowest among all states)
    --- Non-hospital spending (2017): $103.6 million ($77 per capita, #7 lowest)
    --- Public health agency spending (2018): $86.6 million ($63 per capita, 18.6% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Carroll County ($1.9 million total, $40 per capita)
    --- #2. Coos County ($1.1 million total, $35 per capita)
    --- #3. Sullivan County ($1.4 million total, $33 per capita)

    Legislation enacted in 2007 created the Public Health Improvement Services Council, the organization tasked with overseeing New Hampshire's public health improvement initiatives. The council, among other things, conducts regular workshops designed to address the state's six-point public health action plan.

  • #47. Minnesota

    - Total state public health spending (2017): $762.8 million ($137 per capita)
    --- Hospital spending (2017): $332.6 million ($60 per capita, #10 lowest among all states)
    --- Non-hospital spending (2017): $430.2 million ($77 per capita, #8 lowest)
    --- Public health agency spending (2018): $585.9 million ($102 per capita, 3.8% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Big Stone County ($31.3 million total, $6,245 per capita)
    --- #2. Cook County ($28.1 million total, $5,200 per capita)
    --- #3. Kandiyohi County ($125.3 million total, $2,930 per capita)

    Minnesota is putting a heavy focus on remote health care, which has proven to be an indispensable resource during the pandemic. The Minnesota e-Health Initiative represents a collaboration between the government and the private sector. It's overseen by a 25-member council that was created through legislation.

    You may also like: COVID-19 is the latest example of zoonosis—here are 30 other diseases animals transmit to humans

  • #46. Tennessee

    - Total state public health spending (2017): $1.0 billion ($151 per capita)
    --- Hospital spending (2017): $351.3 million ($52 per capita, #9 lowest among all states)
    --- Non-hospital spending (2017): $658.7 million ($98 per capita, #16 lowest)
    --- Public health agency spending (2018): $545.1 million ($79 per capita, 11.7% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Madison County ($676.0 million total, $6,934 per capita)
    --- #2. Maury County ($347.7 million total, $3,770 per capita)
    --- #3. Putnam County ($285.1 million total, $3,688 per capita)

    Tennessee recently restructured the way health care is funded and delivered in the state. The Tennessee Health Care Innovation Initiative is based on three strategies: primary care, episodes of care like surgery or inpatient hospitalization, and long-term services and supports.

  • #45. Illinois

    - Total state public health spending (2017): $2.1 billion ($167 per capita)
    --- Hospital spending (2017): $967.0 million ($76 per capita, #15 lowest among all states)
    --- Non-hospital spending (2017): $1.2 billion ($91 per capita, #13 lowest)
    --- Public health agency spending (2018): $391.6 million ($30 per capita, 12.8% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Whiteside County ($228.9 million total, $4,091 per capita)
    --- #2. Schuyler County ($23.9 million total, $3,440 per capita)
    --- #3. Wabash County ($36.5 million total, $3,167 per capita)

    There are plenty of dentists in Illinois, and child immunization rates are strong, but residents there suffer from excess pollution, and they're more likely to be problem drinkers. The real health care crisis, however, is drug addiction. Drug deaths in Illinois increased by 63% in the last five years alone.

  • #44. Louisiana

    - Total state public health spending (2017): $824.9 million ($177 per capita)
    --- Hospital spending (2017): $378.0 million ($81 per capita, #18 lowest among all states)
    --- Non-hospital spending (2017): $446.9 million ($96 per capita, #14 lowest)
    --- Public health agency spending (2018): $330.4 million ($69 per capita, 16.5% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. St. James Parish ($55.4 million total, $2,590 per capita)
    --- #2. Terrebonne Parish ($279.0 million total, $2,495 per capita)
    --- #3. Tangipahoa Parish ($321.6 million total, $2,430 per capita)

    Louisiana has the benefit of a unique 501(c)(3) called the Louisiana Public Health Institute, which works toward improvements in population-level health. Created through a Concurrent Resolution in 1997, its seven key focus areas include tobacco prevention and control, behavioral health, family health, and HIV/STI.

  • #43. Nevada

    - Total state public health spending (2017): $570.8 million ($192 per capita)
    --- Hospital spending (2017): $285.5 million ($96 per capita, #22 lowest among all states)
    --- Non-hospital spending (2017): $285.4 million ($96 per capita, #15 lowest)
    --- Public health agency spending (2018): $198.3 million ($64 per capita, 25.1% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Humboldt County ($55.5 million total, $3,321 per capita)
    --- #2. White Pine County ($30.2 million total, $3,127 per capita)
    --- #3. Lander County ($17.1 million total, $3,058 per capita)

    Launched in 2018, Nevada's Public Health 3.0 program is an ambitious overhaul of many state services and policies. It places a heavy focus on social health determinants like neighborhoods, schools, employment, income, and diet.

  • #42. South Dakota

    - Total state public health spending (2017): $189.0 million ($217 per capita)
    --- Hospital spending (2017): $25.0 million ($29 per capita, #4 lowest among all states)
    --- Non-hospital spending (2017): $164.0 million ($188 per capita, #21 highest)
    --- Public health agency spending (2018): $108.5 million ($121 per capita, 1.1% down from 2010)
    - Counties spending the most on public health (2017):
    --- #1. Faulk County ($11.0 million total, $4,748 per capita)
    --- #2. Brookings County ($83.4 million total, $2,399 per capita)
    --- #3. Spink County ($10.4 million total, $1,598 per capita)

    The South Dakota Department of Health recently unveiled a five-year plan that will unfold between now through 2025. The plan aims to increase accessibility, improve the health care workforce, forge new private partnerships, plan and prepare for public health emergencies, and improve service-oriented public health.

    You may also like: How COVID-19 projections compare to leading causes of death in America

2018 All rights reserved.