Inaccuracy of Official Estimates of Public Health Spending in the United States, 2000–2018

Bibliographic Data

ID11027977
AuthorsJonathon P Leider (0000-0001-9905-476X, Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis. Jonathon P. Leider and Beth Resnick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. J. Mac McCullough is with the College of Health Solutions, Arizona State University, Phoenix. Y. Natalia Alfonso and David Bishai are with Department of Population, Family and Reproductive Health, Johns Hopkins...), Beth Resnick (0000-0001-6214-9378, Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis. Jonathon P. Leider and Beth Resnick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. J. Mac McCullough is with the College of Health Solutions, Arizona State University, Phoenix. Y. Natalia Alfonso and David Bishai are with Department of Population, Family and Reproductive Health, Johns Hopkins...), J Mac McCullough (0000-0002-0070-4943, Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis. Jonathon P. Leider and Beth Resnick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. J. Mac McCullough is with the College of Health Solutions, Arizona State University, Phoenix. Y. Natalia Alfonso and David Bishai are with Department of Population, Family and Reproductive Health, Johns Hopkins...), Y Natalia Alfonso (0000-0002-7148-4407, Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis. Jonathon P. Leider and Beth Resnick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. J. Mac McCullough is with the College of Health Solutions, Arizona State University, Phoenix. Y. Natalia Alfonso and David Bishai are with Department of Population, Family and Reproductive Health, Johns Hopkins...), David Bishai (0000-0003-0714-9062, Jonathon P. Leider is with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis. Jonathon P. Leider and Beth Resnick are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. J. Mac McCullough is with the College of Health Solutions, Arizona State University, Phoenix. Y. Natalia Alfonso and David Bishai are with Department of Population, Family and Reproductive Health, Johns Hopkins...)
Year2020
Volume110
IssueS2
PagesS194-S196
Publication date2020-07-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2020.305709
PMID32663084
OpenAlexW3043642338
LanguageEN
Citations received5
References cited7

Objectives. To examine the accuracy of official estimates of governmental health spending in the United States. Methods. We coded approximately 2.7 million administrative spending records from 2000 to 2018 for public health activities according to a standardized Uniform Chart of Accounts produced by the Public Health Activities and Services Tracking project. The official US Public Health Activity estimate was recalculated using updated estimates from the data coding. Results. Although official estimates place governmental public health spending at more than $93 billion (2.5% of total spending on health), detailed examination of spending records from state governments shows that official estimates include substantial spending on individual health care services (e.g., behavioral health) and that actual spending on population-level public health activities is more likely between $35 billion and $64 billion (approximately 1.5% of total health spending). Conclusions. Clarity in understanding of public health spending is critical for characterizing its value proposition. Official estimates are likely tens of billions of dollars greater than actual spending. Public Health Implications. Precise and clear spending estimates are material for policymakers to accurately understand the effect of their resource allocation decisions

Demographic economics · Economic growth · Economics · Environmental health · Estimation · Health care · Health services · Health spending · Population · Public economics · Public health · Food Security and Health in Diverse Populations · Healthcare Policy and Management · Medicine · Public Health Policies and Education · Health Policy

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