title: Local public health department funding: trends over time and relationship to health outcomes.
abstract: BACKGROUND
  Local health departments contribute to population health improvement through the core functions of assessment, policy development, and assurance. Their capacity to perform these functions may be affected by funding and staffing.
  
  
  OBJECTIVE
  To describe local health department funding and staffing levels and determine the relationship between these measures and county-level health outcomes.
  
  
  METHODS
  Ten years of total funding, funding by revenue source, and staffing data from local health departments in all 72 Wisconsin counties were collected from the Department of Health and Family Services and analyzed. Summary measures for county health outcomes were obtained from the 2006 Wisconsin County Health Rankings, and a correlation matrix was created to determine associations between outcomes and measures of health department capacity.
  
  
  RESULTS
  On average, Wisconsin local health departments spend $20.60 per capita, ranging from $7.50 to $68.30 among counties. While total per capita funding in the state (adjusted for inflation) increased $0.82 per year, a closer look reveals 3 distinct periods: increases of $0.20 per year during 1995-1997 and $1.33 per year during 1997-2001; but a decrease of $0.27 during 2001-2004. Local health departments in counties with worse health outcomes had only slightly higher average funding and staffing levels during 2002-2004.
  
  
  CONCLUSIONS
  Levels of health department funding in Wisconsin, already low by US standards, declined slightly in the past 3 years. Although counties with the worst health outcomes had slightly higher levels of public health funding, considerable disparities exist. State policymakers might consider investing more resources in counties with the greatest need, to support evidence-based public health programs and reduce existing geographic health disparities in Wisconsin.
authors.affiliation: University of Wisconsin-Madison, Population Health Institute, Madison, WI 53726, USA.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Boeke
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Zahner
authors.forename: Bridget C
authors.initials: BC
authors.lastname: Booske
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Remington
mesh_terms: D005380:Financing, Government / Q000639:trends*; D006801:Humans; D009111:Local Government; D011635:Public Health Administration / Q000191:economics*; D012044:Regression Analysis; D014922:Wisconsin