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Spend a Dollar, Save More Than a Dollar—Public Health

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Courtney Haun
May 18, 2019

Public health spending has the ability to equate cost savings, health savings and life savings. 75 percent of United States health spending goes towards preventable chronic conditions (i.e. obesity and heart disease). But, only 3 cents out of every dollar spent on health care goes towards prevention efforts through public health. ­­­­­­

What if someone told you that each dollar invested in public health often returns more than one dollar in terms of health and financial benefits? Would you believe them? Public health, according to the American Public Health Association (APHA), “Promotes and protects the health of people and the communities where they live, learn, work and play.” Some examples of the many fields of public health include:

  • First responders.
  • Occupational health and safety professionals.
  • Epidemiologists.
  • Health educators.
  • Community planners.
  • Scientists and researchers.

In the science of protecting and improving health, prevention and early detection of morbidity are key. Overall, these fields are interested in protecting the health of the entire population by preventing problems from happening or recurring.

Approximately 5 percent–9 percent of the Gross Domestic Product is spent on public health activities each year in the United States. However, estimating public health spending is difficult because there are a limited number of sources with systematic public health finance data. Leider says that this is because, “Various organizations collect data using different means, data definitions, and inclusion/exclusion criteria—most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates.”

Despite this limitation, across data sources, it is evident that investing in public health saves money. According to the APHA, every dollar spent on prevention can save up to $5.60 in health spending. Interestingly, 75 percent of United States health spending goes towards preventable chronic conditions (i.e. obesity, heart disease). But, only 3 cents out of every dollar spent on health care goes towards prevention efforts through public health. ­­­­­­

Outside of cost-savings alone, public health promotion and prevention programs also have the ability to improve health and extend life longevity. Some examples of these initiatives that are relatively low cost include:

  • Influenza vaccines.
  • Screenings for high blood pressure and high cholesterol.
  • Primary school education regarding the importance of physical activity.
  • Mandatory motor vehicle occupant restraints.

These examples shed light into effective initiatives that can lead not only to improved health but also increased productivity and decreases in organizational expenses for health insurance.

If we are talking dollars here, what exactly can $10 of public health spending buy? The AcademyHealth says that $10 can:

  • Decrease 7.4 percent of infectious disease morbidity and 1.5 percent of premature mortality at the county level.
  • Increase the proportion of the population in very good or excellent health by 0.6 percent.
  • Decrease the number of cases of salmonella per 10,000 people a year by 0.4 percent.
  • Decrease 3-6 percent of county-level STD rates.

Worth it? Based on a poll from 2009, Americans overwhelmingly support investment in prevention. The poll revealed that 76 percent of Americans believe that the level of funding for prevention should be increased. Also, a vast majority believe that prevention will save money, and that we should invest in prevention regardless of whether or not it will save money.

Public health spending can equate to cost savings, health savings and life savings. However, the longer people live, the more they may spend on other health-related programs. For example, if more people quit smoking and those individuals live longer, they may eventually seek long-term care services. If this is the case, to what extent is spending from public health dollars offset?

Almost all arguments for increasing focus on prevention have to do with improving quality of life, and not necessarily reducing healthcare spending (although that is a perk). As Benjamin Franklin put it, “An ounce of prevention is worth a pound of cure.” In other words, spending a dollar to save more than a dollar seems worthwhile. 


Author:
Courtney Haun, MPH
Ph.D. Student
Auburn University
[email protected]

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The American Society for Public Administration is the largest and most prominent professional association for public administration. It is dedicated to advancing the art, science, teaching and practice of public and non-profit administration.

One Response to Spend a Dollar, Save More Than a Dollar—Public Health

  1. Burden S Lundgren Reply

    May 27, 2019 at 2:47 pm

    We have to be careful of the word “prevention” and make a better distinction between prevention as practiced by physicians (much of which – although not all – is highly questionable) and prevention that that is more geared to community interventions. The real prevention payoffs may be more tied to primordial prevention than that which you describe, e.g., clean air and water, adequate nutrition and housing, social support and, above all, education. Countries that spend more on these types of services spend less on health care and have better outcom

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