Shortchanged? An assessment of chronic disease programming in major US city health departments.
A self-administered survey was distributed to members of The Big Cities Health Coalition, a group of Health Officers/Commissioners from 17 of the largest US metropolitan health departments. The survey asked participants about their chronic disease priorities, data sources, budgets, and funding sources as well as examples of successful chronic disease interventions. Members of the Coalition discussed the survey results in a scheduled conference call. Chronic diseases account for 70% of all deaths nationwide on average, yet the health departments surveyed allocated an average of 1.85% of their budgets to chronic disease. Average chronic disease spending per inhabitant was 2.33 dollars, with a median of 1.56 dollars. Among the group's top chronic disease priorities were asthma, diabetes, tobacco, cancer, and cardiovascular disease (CVD). Nearly half of the group's chronic disease spending was on tobacco. Chronic disease funding sources varied across localities, but direct federal funding was minimal. In 14 cities serving a combined 37 million people (13% of the US population), direct federal chronic disease funding totaled 8.7 million dollars, an average of 0.24 dollars per capita. The group described successful chronic disease interventions, particularly related to tobacco and asthma.
Georgeson
Mari
M
New York City Department of Health and Mental Hygiene, New York, NY 10013, USA. mgeorges@health.nyc.gov
Thorpe
Lorna E
LE
Merlino
Mario
M
Frieden
Thomas R
TR
Fielding
Jonathan E
JE
D002017:Budgets; D002908:Chronic Disease / Q000191:economics*; D002947:Cities; D005380:Financing, Government; D006265:Health Care Coalitions; D006292:Health Priorities / Q000145:classification*; D006306:Health Surveys; D006801:Humans; D009111:Local Government; D011635:Public Health Administration / Q000191:economics*; D014481:United States; D014504:Urban Health