The purpose of this study was to assess the alignment of state and local health department financing with the 10 essential public health service (10EPHS) categories and National Public Health Performance Standards (NPHPS). To determine this, we collected primary data from the Florida Department of Health (FDOH) for fiscal year 2005–2006 and compared it with secondary data collected in the same year through NPHPS survey instruments. A structured interview technique was used to collect primary budget data from each program office at the FDOH and assign each program budget to 10EPHS categories. Local county health department (CHD) expenditures were assessed through an interview with the director and budget chief of one small, medium, and large CHD, and results were then extrapolated for other local CHDs. It was possible for almost 98 percent of the FDOH budget to be allocated into the 10EPHS categories. A majority of resources (68.7%) were used for individual healthcare services, category 7b (assuring provision of services) and category 7a (linking people to needed services). No direct correlation was found between the level of funding by 10EPHS category and the performance standards scores at state or local levels. Public health continues to utilize a majority of its available resources for individual healthcare services, despite increasing requests for improved population-based programs.
This study aims to assess the alignment of state and local health department financing with the 10 essential public health service categories and national public health performance standards.
Robert G. Brooks, MD, MBA, MPH, is Associate Dean for Health Affairs and Professor of Family Medicine and Rural Health at the Florida State University College of Medicine. He is board-certified in Internal Medicine, Infectious Diseases, and Preventive Medicine. He previously served as Secretary of the Florida Department of Health, and prior to that as a member of the Florida House of Representatives.
Leslie M. Beitsch, MD, JD, is Professor and Director of the Center on Medicine and Public Health, Division of Health Affairs, Florida State University College of Medicine, Tallahassee.
Phil Street, MPA, is Research Manager with Florida Department of Health, Office of Health Statistics and Community Assessment, Tallahassee.
Askar Chukmaitov, MD, PhD, is Assistant Professor and Director of the Center on Global Health, Division of Health Affairs, Florida State University College of Medicine, Tallahassee
Corresponding Author: Robert G. Brooks, MD, MBA, MPH, Division of Health Affairs, Department of Family Medicine and Rural Health, Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL 32306 (firstname.lastname@example.org).
The authors thank Howard Koh, MD, MPH, at the Harvard School of Public Health for his assistance.