Wisconsin Near Bottom in Public Health Spending

Concerns about the threats posed by the Zika virus have generated debate in Congress about funding for public health and have drawn attention to the importance of public health systems. That makes this a very appropriate time to also look at the funding for our state and local public health departments.

In Wisconsin, as in other states, we expect a lot from the public health system. However, we generally take that system for granted, and Wisconsin has one of the most poorly funded public health systems in the nation.

A recent report by the Trust for America’s Health (Investing in America’s health: a state-by-state look at public health funding and key health facts) compares the total spending level for public health in each state in 2015, and it also ranks states by the public health funding from a variety of sources. That report reveals the following:

• Wisconsin had the third lowest level of total spending for public health per capita, ranking 48^th nationally, as the following graph illustrates.
• If we focus on just the funding from state revenue, Wisconsin was among the bottom ten states, ranking 41^st last year.
• Wisconsin’s state funding for public health, $15.10 per capita, was 55 percent below the median level among all states.

Wisconsin’s very low level of spending for public health compared to other states is a significant concern – both because of the importance of public health departments and because other states haven’t set the bar very high. As the report from Trust for America’s Health states:

“…the public health system has been chronically underfunded for decades. Analyses from the Institute of Medicine (IOM), The New York Academy of Medicine (NYAM), the U.S. Centers for Disease Control and Prevention (CDC) and a range of other experts have found that federal, state and local public health departments have been hampered due to limited funds and have not been able to adequately carry out many core functions, including programs to prevent diseases and prepare for health emergencies.”

The report also describes the vitally important role of public health departments:

“Investments in public health are essential for tackling the biggest health problems facing the country. They help prepare for and control emerging and persistent threats, from the Zika virus to the Middle Eastern Respiratory Syndrome (MERS) to antibiotic resistance to the dramatic rise in prescription painkiller and heroin use to contaminated water and other sources of lead poisoning in communities to obesity and tobacco use and related chronic diseases.”

Wisconsin is not immune to those sorts of public health threats. Many times each week we see stories about significant public health issues in our state, such as the Isthmus article today about the explosion in opioid overdoses in the Madison area. Other examples turned up by a quick search include stories about Lyme disease, norovirus outbreaks, West Nile Virus, lead in drinking water,contamination from septic waste, and other types of well water contamination – among many other public health threats.

Keeping up with all these threats is extremely difficult for local governments whose budgets have been squeezed by state-imposed limits on property taxes and cuts in state shared revenue. Yet it is critically important to be vigilant and head off potential public health problems before they become huge and very costly health crises. Flint, Michigan provides a very compelling yet tragic example of the tremendous human and financial cost of not adequately monitoring and responding to public health risks.

State lawmakers need to take a hard look at the capacity of Wisconsin’s public health system to respond to the opioid epidemic and all the other public health threats, and then ensure that tightfisted spending on public health doesn’t cost Wisconsinites far more in the long run.

By Jon Peacock and Joanne Brown