title: Local health departments and specific maternal and child health expenditures:  relationships between spending and need.
abstract: OBJECTIVE
  As a part of the Public Health Activities and Service Tracking study and in collaboration with partners in 2 Public Health Practice-Based Research Network states, we examined relationships between local health department (LHD) maternal and child health (MCH) expenditures and local needs.
  
  
  METHODS
  We used a multivariate pooled time-series design to estimate ecologic associations between expenditures in 3 MCH-specific service areas and related measures of need from 2005 to 2010 while controlling for other factors.
  
  
  METHODS
  Retrospective expenditure data from LHDs and for 3 MCH services represented annual investments in (1) Special Supplemental Nutrition for Women, Infants, and Children (WIC), (2) family planning, and (3) a composite of Maternal, Infant, Child, and Adolescent (MICA) service. Expenditure data from all LHDs in Florida and Washington were then combined with "need" and control variables.
  
  
  METHODS
  Our sample consisted of the 102 LHDs in Florida and Washington and the county (or multicounty) jurisdictions they serve.
  
  
  RESULTS
  Expenditures for WIC and for our composite of MICA services were strongly associated with need among LHDs in the sample states. For WIC, this association was positive, and for MICA services, this association was negative. Family planning expenditures were weakly associated, in a positive direction.
  
  
  CONCLUSIONS
  Findings demonstrate wide variations across programs and LHDs in relation to need and may underscore differences in how programs are funded. Programs with financial disbursements based on guidelines that factor in local needs may be better able to provide service as local needs grow than programs with less needs-based funding allocations.
authors.affiliation: Department of Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA 98195, USA. bettybek@uw.edu
authors.forename: Betty
authors.initials: B
authors.lastname: Bekemeier
authors.forename: Matthew
authors.initials: M
authors.lastname: Dunbar
authors.forename: Matthew
authors.initials: M
authors.lastname: Bryan
authors.forename: Michael E
authors.initials: ME
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005431:Florida; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D009111:Local Government; D008430:Maternal-Child Health Centers / Q000191:economics*; D012189:Retrospective Studies; D014861:Washington