Budget cuts and health outcomes: Examining a natural experiment

Psychosocial & Community Health
Robert Wood Johnson Foundation
Project Period: 
December 1, 2011 to November 30, 2013
Research Project Staff: 
Principal Investigator

The nations economic recession is dramatically impacting the level of resources available to local health departments (LHDs) and undermining their capacity to deliver services to their communities. At the same, time public health officials operate with an extremely underdeveloped evidence base about the impacts of public health services on population health. The unfortunate economic crisis provides a unique natural experiment to examine relationships between changes in LHD expenditures for specific LHD services and changes in population health behaviors and proximal health outcomes on the county level. Our study will use longitudinal LHD expenditure data for categories of service expenditures (i.e. Maternal/Child Health, Environmental Health, Communicable Disease Control) in 305 LHDs from 4 states over 6 years (2005-2010). Unique and critical partnerships with Public Health Practice-based Research Networks (PBRN) and the University of Washingtons Center for Studies in Demography and Ecology (CSDE) will underlie the promising and innovative geospatial and statistical approach we will use to examine a poorly understood area of Public Health Systems and Services Research (PHSSR). Understanding these relationships is vital to developing an evidence base for public health planning and decision-making.