Pa. and N.J. rank low in spending on public health

Pennsylvania and New Jersey spend fewer federal dollars per person on disease and injury prevention than any other states in the Northeast and both rank near the bottom nationwide, according to an analysis of public health funding released yesterday.

Pennsylvania's state health budget is also the lowest in the Northeast.

The report aims to highlight stagnating spending on public health in the United States at a time of heightened concern about pandemics, chronic diseases, foodborne pathogens and bioterrorism.

"Public health departments are responsible for finding ways to address the systemic reasons why some communities are healthier than others and for developing policies and programs to remove obstacles that get in the way of making health choices possible," Jeffrey Levi, executive director of the Trust for America's Health, said in a statement. "But right now, public health departments do not have the resources they need to improve health in communities."

Yesterday's report was a joint effort of Levi's organization and the Robert Wood Johnson Foundation. RWJF last month presented another report that detailed wide disparities in people's health status according to where they live, with residents of low-income cities like Philadelphia having shorter lifespans, on average, than residents of high-income areas such as Chester County.

Excluding one-time funding to stimulate the economy, support for public health from the U.S. Centers for Disease Control and Prevention has been relatively flat for five years. Most of the CDC's budget is distributed to states and other entities to support programs ranging from HIV testing to obesity prevention, and that federal money often equals half or more of what the states themselves spend, according to the new report.

Federal funding for each state varies widely, depending on the size and needs of the population, and applications for competitve grants.

For fiscal year 2009, the report found, states received an average of $19.23 per capita from the CDC. Pennsylvania got $14.86 per capita (a total of $187,352,742), ranking it 47th of the 50 states. New Jersey got $16.67 ($145,144,429), No. 40. Delaware got $27.26 ($24,130,888), No. 8.

State treasuries nationwide budgeted a median of $28.92 per capita for health in fiscal year 2009, the report said. Pennsylvania spent $19.64 per person (a total of $247,514,000), down 1.2 percent from 2008, ranking it 39th in the nation. New Jersey spent $32.38 ($281,987,000), down 6.1 percent, for No. 24. Delaware spent $52.77 ($46,709,500), up 2.6 percent, No. 13.

Because the report attempted to analyze budgets in a way that allowed comparisons among states that budget in very different ways, its numbers may not match figures put out by each state. And true comparisons were not always possible; Pennsylvania and Delaware were among the states whose numbers included only general funds, for example.

The analysis also ended with the fiscal year that concluded last June. Since then, many states have slashed budgets in response to lower tax revenues in the economic downturn.

Gov. Rendell's health department budget was down 12 percent for the current fiscal year, with a smaller cut proposed for the year that begins July 1, 2010, according to numbers from Harrisburg. New Jersey's budget for the Department of Health and Senior Services was slashed 27 percent for this fiscal year under former Gov. Jon Corzine, and Gov. Christie wants to cut more this year.

The foundations' report did cite one potential bright spot. The health-reform bills that passed the House and the Senate each contain several billion dollars in new funding for school-bassed health clinics, childhood obesity prevention and other public health programs, some of them intended to reduce health-care costs over the long haul. In theory, those programs could be approved separately even if comprehensive healthcare legislation is defeated.

Besides supporting more money for public health, the new report - titled "Shortchanging America's Health" - said that "government should be held acountable for showing that is is spending public health dollars effectively." It also called for a National Prevention Strategy that would focus on keeping people healthy rather than mainly treating them after illness sets in.

Contact staff writer Don Sapatkin at 215-854-2617 or dsapatkin@phillynews.com.