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Funding Formulas for Public Health Allocations: Federal and State Strategies

Ogden, Lydia L. PhD, MPP; Sellers, Katie DrPH; Sammartino, Cara BS; Buehler, James W. MD; Bernet, Patrick M. PhD

Journal of Public Health Management and Practice: July/August 2012 - Volume 18 - Issue 4 - p 309–316
doi: 10.1097/PHH.0b013e3182431d8f
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Public health funding formulas have received less scrutiny than those used in other government sectors, particularly health services and public health insurance. We surveyed states about their use of funding formulas for specific public health activities; sources of funding; formula attributes; formula development; and assessments of political and policy considerations. Results show that the use of funding formulas is positively correlated with the number of local health departments and with the percentage of public health funding provided by the federal government. States use a variety of allocative strategies but most commonly employ a “base-plus” distribution. Resulting distributions are more disproportionate than per capita or per-person-in-poverty allotments, an effect that increases as the proportion of total funding dedicated to equal minimum allotments increases.

This study describes a survey of states about their use of funding formulas for specific public health activities; sources of funding; formula attributes; formula development; and assessments of political and policy considerations.

Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia (Dr Ogden); Association of State and Territorial Health Officials, Arlington, Virginia (Dr Sellers); Brown University, Providence, Rhode Island (Ms Sammartino); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia (Dr Buehler); and Florida Atlantic University, Boca Raton (Dr Bernet). Dr Ogden is currently Director, Office of Health Reform Strategy, Policy, and Coordination, Centers for Disease Control and Prevention, Atlanta, Georgia.

Correspondence: Lydia L. Ogden, PhD, MPP, Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 (logden@emory.edu).

Disclosure: This research was partly funded through a grant from the Robert Wood Johnson Foundation.

The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.