Objective: This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs.
Design: We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections.
Setting: The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota.
Participants: For each of the methods, we selected a panel to represent a profile of Minnesota health departments.
Main Outcome Measures: The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level.
Results: The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities.
Conclusions: It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.
This study aims to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs.
Department of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, (Dr Riley and Mr McCullough); and Chisago County Department of Health, Chisago Lakes, Minnesota (Ms Briggs).
Correspondence: William Riley, PhD, 420 Delaware St SE, Mayo Mail Code 197, Minneapolis, MN 55455 (firstname.lastname@example.org).
This study would not have been possible without the generous sharing of expertise and wisdom of local public health directors in Minnesota and their colleagues from the Minnesota Department of Health. The authors thank Kari Guida, MPH; Carmen Parrotta, MPH; Helen Parsons, MPH; and Niveta Giotra, MD, for their contributions to this study. We appreciate very much the suggestions and helpful comments from their peer reviewers.
Funding for this project was received from UCare Minnesota, and the Robert Wood Johnson Foundation. Important support was also provided by the Minnesota Department of Health. Sponsors were not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Disclosure: The authors report no conflicts of interest.