7.4 Public Health Financing

Public health focuses on promoting community well-being through prevention and addressing health disparities. Its core functions include assessment, policy development, and assurance, with funding from federal, state, and local sources. The CDC plays a crucial role in supporting these efforts nationwide.

Challenges in public health funding include chronic underfunding, competition for resources, and inflexible funding mechanisms. Stable funding streams are essential for effective public health initiatives, highlighting the need for dedicated sources and increased investment in infrastructure and workforce.

Public Health and Its Financing

Core functions of public health

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• Public health focuses on promoting and protecting the health of communities and populations with an emphasis on prevention, health promotion, and addressing health disparities
• Assessment involves monitoring health status, identifying community health needs, and investigating health problems and hazards
• Policy development includes informing and empowering people about health issues, mobilizing community partnerships, and developing policies that support individual and community health efforts
• Assurance ensures enforcement of laws protecting health and safety, linking people to needed health services, assuring a competent healthcare workforce, evaluating effectiveness and quality of health services, and researching innovative solutions to health problems

Funding sources for public health

• Federal funding sources include the Department of Health and Human Services (HHS) agencies like the Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), and National Institutes of Health (NIH), as well as the Department of Agriculture (USDA) and Environmental Protection Agency (EPA)
• State funding sources comprise state general funds, dedicated revenue streams (tobacco taxes, fees), and federal grants and cooperative agreements
• Local funding sources include local government general funds, dedicated local taxes or fees, state and federal grants, and private foundations and donations

CDC's role in health financing

• CDC serves as the nation's leading public health agency, conducting and supporting health promotion, prevention, and preparedness activities while working with state and local health departments to improve public health
• CDC provides funding through cooperative agreements with state and local health departments, grants for specific public health programs and research, and direct assistance by deploying CDC staff and resources
• CDC plays a crucial role in emergency response and preparedness by providing funding and technical assistance for emergency preparedness planning and supporting rapid response to public health emergencies and disease outbreaks (COVID-19 pandemic, Ebola outbreak)

Challenges of public health funding

• Public health infrastructure suffers from chronic underfunding due to a lack of sustained investment in core functions and difficulty in quantifying the return on investment for prevention activities
• Public health often competes with other pressing issues for limited government resources, and prevention efforts may be seen as less urgent than immediate crises
• Public health emergencies require rapid mobilization of resources, but existing funding mechanisms may not be flexible enough to accommodate sudden needs, leading to dependence on emergency supplemental funding from the federal government
• Stable and predictable funding streams are essential for public health, emphasizing the importance of dedicated funding sources, advocacy for increased investment in public health infrastructure and workforce, and recognition of public health's role in promoting health, preventing disease, and protecting communities