Report at a Glance
Reallocation of Health Dollars and New Sources of Funds Needed to Strengthen Nation's Public Health Capacity
To improve America's lackluster performance on health outcomes compared with its peer nations and to maintain its international competitiveness, the United States needs to invest more in its chronically underfunded public health system and spend public health dollars more efficiently, says a new report from the Institute of Medicine.
The United States spends more on health than other nations — almost $2.5 trillion in 2009 — and yet scores lower than other wealthy nations on life expectancy, infant mortality, and other indicators of population health, the report notes. Rising health care spending diverts funds from education, business development, and other investments that keep nations globally competitive. The chronic diseases that drive the bulk of U.S. health spending are conditions that could be decreased or prevented through the initiatives, services, and expertise that public health departments provide. However, only a small fraction of U.S. health dollars goes to government-administered public health — just 3.1 percent in 2009, according to the Centers for Medicare and Medicaid's National Health Expenditure Accounts, which amounts to $251 per person in public health spending compared with $8,086 per person in medical care spending.