Public Health Budgets

It was disheartening to see Rachel Crumpler include this paragraph in an otherwise very compelling story on local health department spending.

Spending on public health at the state level from 2010 to 2018 dropped by more than 27% when adjusted for inflation and population increase, according to an analysis by Kaiser Health News and the Associated Press of data from the Association of State and Territorial Health Officials. This spending decline is even steeper than the national slide of 16% across all states.

But as I wrote when a left-leaning advocacy group started spreading this line in March:

This claim combines bad math, bad history, and a bad understanding of state government. Budgeted expenditures for the Division of Public Health in the Department of Health and Human Services dropped 17%, from $189.0 million to $156.6 million between FY 2008-09 and FY 2010-11, both periods when Democrats remained in control of the General Assembly and well before any tax cuts. This spending covers programs for food assistance, sickle cell anemia, and HIV/AIDS with programs related to the coronavirus outbreak. The budget bill for FY 2018-19 appropriated $156.7 million.

Looking closely at the segment of public health spending for pandemics (i.e., public health preparedness and response, capacity building, the chief medical examiner, state health lab, and communicable disease surveillance), appropriations have grown from $24.9 million in FY 2014-15, the first full year of tax reform, to $34.6 million between in the current 2019-20 fiscal year, according to the OSBM’s Open Budget website. Federal funds have increased from $35.8 million to $59.1 million, bringing total expenditures that could help with coronavirus to $93.7 million, a 54% increase from the $60.7 million spent five years ago. Higher spending is not necessarily better spending, but these increases belie the claim that the General Assembly has prioritized tax cuts over public health.

Joseph Coletti / Senior Fellow, Fiscal Studies

Joe Coletti is a senior fellow at the John Locke Foundation focused on fiscal policy issues. He previously headed the North Carolina Government Efficiency and Reform initiativ...