"Public health is underfunded to meet the demands of an aging population and is further threatened by terrorism and natural disasters."
FSU study draws attention to U.S. public health spending
by Doug Carlson
Public health systems in the United States are understaffed and insufficiently funded to meet threats from bioterrorism, pandemic disease and natural disasters, according to a current study conducted by researchers at the Florida State University College of Medicine.
Lead researcher Dr. Les Beitsch, director of the college's Center on Medicine and Public Health, analyzed 2005 surveys of state and local public health agencies and found that mean per capita spending for public health in 2004-2005 was $149, compared to $6,423 for overall health care. Overall health care expenditures include payments made by individuals, private insurance companies and programs such as Medicare and Medicaid for items ranging from doctor visits and prescription drugs to dental care and over-the-counter drugs and medical products.
The study, appearing in the July/August issue of Health Affairs, notes that public health systems have evolved from focusing on infectious disease and hygiene promotion to preventing and treating chronic disease and now to emergency preparedness and response.
As new issues are identified and brought into focus in part through events such as the Sept. 11 terrorist attacks, Hurricane Katrina and the emergence of the bird flu virus, public health agencies are not necessarily able to scale back old responsibilities.
"Public health is underfunded to meet the demands of an aging population and is further threatened by terrorism and natural disasters. As health departments take on new roles and responsibilities, old functions are rarely jettisoned,'' said Beitsch, a professor of family medicine at FSU and former commissioner of health in Oklahoma.
Beitsch conducted the study along with Dr. Robert Brooks, associate dean for health affairs at the FSU College of Medicine, and Nir Menachemi, director of the college's Center on Patient Safety.
The study is based on surveys conducted by the Association for State and Territorial Health Officials and the National Association of County and City Health Officials and examines staffing levels and per capita public health expenditures.
Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.
Beitsch's study asks policymakers to examine the proper range of health department functions, provide adequate systems for tracking public health expenditures and staffing levels and to double federal investments in public health over the next 10 years.