The Foundational Public Health Services as a Framework for Estimating Spending

Area of Science:

• Public Health
• Health Services Research
• Health Economics

Background:

• The National Academy of Medicine recommended a minimum package of public health services to improve population health and control costs.
• The Foundational Public Health Services (FPHS) framework was developed to define essential public health programs and capabilities.
• Accurate cost estimation for FPHS is crucial but remains underdeveloped, hindering resource allocation and impact assessment.

Purpose of the Study:

• To estimate state governmental spending on Foundational Public Health Services (FPHS).
• To address the knowledge gap in quantifying the resources required for universal FPHS availability.
• To provide a foundation for future research on FPHS spending and its impact.

Main Methods:

• A coding framework based on the FPHS was developed.
• 1.9 million U.S. Census Bureau State Finance non-hospital expenditure records from 49 states (2000-2013) were coded.
• Estimates of state governmental FPHS spending were generated.

Main Results:

• Foundational Public Health Services (FPHS) spending comprised 36% of total state governmental non-hospital health spending between 2008 and 2013.
• Maternal and child health services received the largest share of FPHS expenditures.
• Access and linkage to clinical care represented the smallest proportion of FPHS spending.

Conclusions:

• This study represents a significant advancement in estimating the resources needed for Foundational Public Health Services (FPHS), as called for by the National Academy of Medicine.
• The developed estimates enable cross-state comparisons of FPHS spending.
• Findings can inform future research aimed at evaluating the impact and effectiveness of FPHS investments.