Ohio is 47th among states when it comes to public health funding received from the federal Centers for Disease Control and Prevention, a new report found.
In the fiscal year ending Sept. 30, the state received about $207 million from the agency, or $17.68 per Ohioan, according to "The Impact of Chronic Underfunding on America's Public Health System" released Wednesday by the Trust for America's Health.
That compares with $63.28 per person in Alaska, which ranks first among the 50 states, and $17.09 per person in New Jersey, which ranks last. The District of Columbia had the highest reimbursement reported at $171.52 per person, but that figure was not included among the state rankings. Puerto Rico and other U.S. territories also were not included.
Beth Bickford, executive director of the Association of Ohio Health Commissioners, said the report demonstrates a disconnect between the amount allocated to Ohio by the CDC and the state's population ranking, which is 7th, according to recent U.S.Census Bureau estimates.
She said it also helps explain challenges Ohio faces in reducing smoking, infant mortality and other long-term indicators of a community's health.
"It's amazing to me the work that gets done with so little funding," Bickford said. "... But we certainly could be doing better if we were able to get more federal funding."
The Ohio Department of Health actively pursues grants offered by the CDC to support state and local public health initiatives, said J.C. Benton, department spokesman.
He said the governor has included state level investments in public health in his two-year budget proposal.
"Governor Mike DeWine is proposing significant investments to address public health issues including but not limited to the drug epidemic, infant mortality, child lead poisoning, and tobacco use and youth vaping," Benton said in an email.
DeWine has also proposed the creation of a Public Health Fund to pull together public and private agencies and funding to increase public health awareness, education, programming and prevention strategies, Benton said.
Of the CDC money allocated to the state, nearly 60 percent — about $122 million — was targeted toward vaccines for children; the rest was spread among a dozen other initiatives, including public health preparedness and response (about $18 million), injury prevention and control (about $12 million) and birth defects, developmental disabilities and disability and health (about $550,000).
The report does not include CDC funding from the Prevention and Public Health Fund in its rankings because, researchers said, it is a first-of-its-kind, dedicated source of funding for public health and prevention created by the Affordable Care Act. Ohio received more than $16 million from the fund in fiscal year 2018.
Federal funding that helps support public health also comes from a number of other agencies in the U.S. Department of Health and Human Services, the report noted.
Benton said Ohio received funds from the Health Resources and Services Administration to address infant mortality and early childhood readiness, as well as funding from the U.S. Department of Housing and Urban Development for lead poisoning prevention activities. He said the Ohio Department of Mental Health and Addiction Services receives significant funding from the Substance Abuse and Mental Health Services Administration.
Ohio's public health funding did increase by 5.8 percent from fiscal year 2017 to fiscal year 2018, according to the report.
Yet Ohio also ranks poorly — 46th — in a separate analysis of public health funding at the state level, based on 2017 numbers, said Amy Bush Stevens, vice president at the non-profit Health Policy Institute of Ohio, which released that dashboard.
Stevens said it is important to remember, however, that much of Ohio's public health funding is generated at the local level.
Local health departments get about 75 percent of funding from local communities, through a combination of licensing and other fees, property taxes and/or tax levies. Bickford said. The rest comes from the Ohio Department of Health's budget — the bulk of it originating from federal dollars and a tiny percentage from state funds.
The state gets about 75 percent of its funding from federal sources and the rest from state funds, she said.
Bickford said DeWine has been supportive of public health and wanting to correct funding issues and suggested that state and local departments could work together to maximize efforts to obtain federal grants.
Tara Britton, director of public policy and advocacy at the Center for Community Solutions, a Cleveland-based research group, said many of DeWine's budget proposals appear to target certain issues "further upstream," by investing in prevention measures that may not show immediate pay off. Among them, she said, are raising the legal age to buy tobacco to 21 and providing mental health assessment services in schools in response to the opioid crisis.
"It may not really be the way we think about traditional public health agencies or public health departments," she said.