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2.
J Public Health Manag Pract ; 27(5): 492-500, 2021.
Article in English | MEDLINE | ID: covidwho-1501235

ABSTRACT

OBJECTIVES: To examine levels of expenditure and needed investment in public health at the local level in the state of Ohio pre-COVID-19. DESIGN: Using detailed financial reporting from fiscal year (FY) 2018 from Ohio's local health departments (LHDs), we characterize spending by Foundational Public Health Services (FPHS). We also constructed estimates of the gap in public health spending in the state using self-reported gaps in service provision and a microsimulation approach. Data were collected between January and June 2019 and analyzed between June and September 2019. PARTICIPANTS: Eighty-four of the 113 LHDs in the state of Ohio covering a population of almost 9 million Ohioans. RESULTS: In FY2018, Ohio LHDs spent an average of $37 per capita on protecting and promoting the public's health. Approximately one-third of this investment supported the Foundational Areas (communicable disease control; chronic disease and injury prevention; environmental public health; maternal, child, and family health; and access to and linkages with health care). Another third supported the Foundational Capabilities, that is, the crosscutting skills and capacities needed to support all LHD activities. The remaining third supported programs and activities that are responsive to local needs and vary from community to community. To fully meet identified LHD needs in the state pre-COVID-19, Ohio would require an additional annual investment of $20 per capita on top of the current $37 spent per capita, or approximately $240 million for the state. CONCLUSIONS: A better understanding of the cost and value of public health services can educate policy makers so that they can make informed trade-offs when balancing health care, public health, and social services investments. The current environment of COVID-19 may dramatically increase need, making understanding and growing public health investment critical.


Subject(s)
Health Care Costs/statistics & numerical data , Health Services Needs and Demand/economics , Public Health Practice/economics , Public Health/economics , COVID-19/economics , Financing, Government/economics , Humans , Local Government , Ohio
5.
Front Biosci (Landmark Ed) ; 26(6): 149-170, 2021 05 30.
Article in English | MEDLINE | ID: covidwho-1281063

ABSTRACT

The disease COVID-19 caused by SARS-CoV-2 is the third highly infectious human Coronavirus epidemic in the 21s⁢t century due to its high transmission rate and quick evolution of its pathogenicity. Genomic studies indicate that it is zoonotic from bats. The COVID-19 has led to significant loss of lives and a tremendous economic decline in the world. Generally, the population at risk of a fatal outcome are the elderly and those who are debilitated or are immune compromised. The fatality rate is high, but now is reduced after the development of preventive vaccine although an effective treatment by drug against the virus is yet to be developed. The treatment is narrowed to the use of several anti-viral drugs, or other re-purposed drugs. Social distancing, therefore, has emerged as a putative method to decrease the rate of infection. In this review, we summarize the aspects of the disease that is so far have come to light and review the impact of the infection on our society, healthcare, economy, education, and environment.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19 Vaccines/administration & dosage , COVID-19/drug therapy , Communicable Disease Control/methods , SARS-CoV-2/drug effects , COVID-19/epidemiology , COVID-19/virology , COVID-19 Vaccines/immunology , Disease Outbreaks/prevention & control , Hand Disinfection/methods , Humans , Physical Distancing , Public Health/economics , Public Health/methods , SARS-CoV-2/immunology , SARS-CoV-2/physiology
6.
Am J Public Health ; 110(S2): S194-S196, 2020 07.
Article in English | MEDLINE | ID: covidwho-1242253

ABSTRACT

Objectives. To examine the accuracy of official estimates of governmental health spending in the United States.Methods. We coded approximately 2.7 million administrative spending records from 2000 to 2018 for public health activities according to a standardized Uniform Chart of Accounts produced by the Public Health Activities and Services Tracking project. The official US Public Health Activity estimate was recalculated using updated estimates from the data coding.Results. Although official estimates place governmental public health spending at more than $93 billion (2.5% of total spending on health), detailed examination of spending records from state governments shows that official estimates include substantial spending on individual health care services (e.g., behavioral health) and that actual spending on population-level public health activities is more likely between $35 billion and $64 billion (approximately 1.5% of total health spending).Conclusions. Clarity in understanding of public health spending is critical for characterizing its value proposition. Official estimates are likely tens of billions of dollars greater than actual spending.Public Health Implications. Precise and clear spending estimates are material for policymakers to accurately understand the effect of their resource allocation decisions.


Subject(s)
Public Health/economics , State Government , Health Expenditures/statistics & numerical data , Humans , United States
7.
Rev Clin Esp (Barc) ; 221(7): 400-403, 2021.
Article in English | MEDLINE | ID: covidwho-1233596

ABSTRACT

OBJECTIVE: To analyze the association between public health expenditure per capita and the mortality rate due to COVID-19 in Europe and Spain. MATERIAL AND METHODS: Pearson's correlation coefficient was used to compare and contrast the mortality rate due to COVID-19 between countries and autonomous communities with higher and lower public health expenditure per capita than the mean. RESULTS: No correlation between the public health expenditure per capita and the mortality rate due to COVID-19 (r: 0.3; p = 0.14) was found among European countries or Spain's Autonomous Communities (r: 0.03; p = 0.91). No significant differences were found when comparing the mortality rate due to COVID-19 among the public health expenditure per capita groups. CONCLUSIONS: The available evidence does not support association between «low¼ public healthcare expenditure and the poor outcomes observed in Spain during the COVID-19 pandemic. Increased funding for the Spanish National Health System should be earmarked for structural reforms to increase its social efficiency.


Subject(s)
COVID-19/mortality , Health Expenditures , Public Health/economics , Europe/epidemiology , Humans , Spain/epidemiology
8.
Can J Public Health ; 112(2): 186-190, 2021 04.
Article in English | MEDLINE | ID: covidwho-1229505

ABSTRACT

Inspired by Fiset-Laniel et al.'s (2020) article entitled "Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada", we assessed public health investments since the establishment of the Nova Scotia provincial health authority in 2015. We analyzed Nova Scotia Department of Health and Wellness budgets from 2015-2016 to 2019-2020 and observed that less than 1% of funding was budgeted for public health annually, an amount well below the recommendation that 5-6% of healthcare funding be spent on public health. Healthcare spending has increased annually since 2015-2016, but proportions of funding to different programs and services have remained static. Specifically, we did not observe a change in investment in public health over time, suggesting that while the government does not necessarily spend too much or too little on healthcare, it spends far too little on public health. This chronic under-funding is problematic given the high rates of non-communicable diseases in Nova Scotia and health inequities experienced within the population. The 2020 COVID-19 pandemic has highlighted the importance of public health work, and the need for a pandemic recovery plan that prioritizes investment in all areas of public health in Nova Scotia.


Subject(s)
Budgets/trends , Financing, Government/economics , Public Health/economics , COVID-19 , Health Status Disparities , Humans , Noncommunicable Diseases/epidemiology , Nova Scotia/epidemiology
11.
Health Aff (Millwood) ; 40(4): 664-671, 2021 04.
Article in English | MEDLINE | ID: covidwho-1150563

ABSTRACT

The COVID-19 pandemic has prompted concern about the integrity of the US public health infrastructure. Federal, state, and local governments spend $93 billion annually on public health in the US, but most of this spending is at the state level. Thus, shoring up gaps in public health preparedness and response requires an understanding of state spending. We present state spending trends in eight categories of public health activity from 2008 through 2018. We obtained data from the Census Bureau for all states except California and coded the data by public health category. Although overall national health expenditures grew by 4.3 percent in this period, state governmental public health spending saw no statistically significant growth between 2008 and 2018 except in injury prevention. Moreover, state spending levels on public health were not restored after cuts experienced during the Great Recession, leaving states ill equipped to respond to COVID-19 and other emerging health needs.


Subject(s)
COVID-19/epidemiology , Health Expenditures , Public Health/economics , COVID-19/economics , Financing, Government , Humans , Pandemics , United States/epidemiology
13.
Am J Public Health ; 111(4): 602-603, 2021 04.
Article in English | MEDLINE | ID: covidwho-1133765
16.
Am J Public Health ; 111(4): 604-605, 2021 04.
Article in English | MEDLINE | ID: covidwho-1133755
19.
J Prev Med Hyg ; 61(4): E520-E524, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1102690

ABSTRACT

In late December 2019, the first case of an emerging coronavirus was identified in the city of Wuhan, Hubei province, in mainland China. The novel virus appears to be highly contagious and is rapidly spreading worldwide, becoming a pandemic. The disease is causing a high toll of deaths. Effective public health responses to a new infectious disease are expected to mitigate and counteract its negative impact on the population. However, time and economic-financial constraints, as well as uncertainty, can jeopardize the answer. The aim of the present paper was to discuss the role of Universal Health Coverage to counteract the economic impact of the COVID-19 infection. Appropriate financing of the health system and ensuring equitable access to health services for all can, indeed, protect individuals against high medical costs, which is one of the most important goals of any health system. Financing profoundly affects the performance of the health system, and any policy that the health system decides to implement or not directly depends on the amount of available funding. Developed countries are injecting new funding to cope with the disease and prevent its further transmission. In addition to psychological support and increased societal engagement for the prevention, control, and treatment of COVID-19, extensive financial support to governments by the community should be considered. Developed and rich countries should support countries that do not have enough financial resources. This disease cannot be controlled and contained without international cooperation. The experience of the COVID-19 should be a lesson for further establishing and achieving universal health coverage in all countries. In addition to promoting equity in health, appropriate infrastructure should be strengthened to address these crises. Governments should make a stronger political commitment to fully implement this crucial set of policies and plans.


Subject(s)
COVID-19/economics , Global Health/economics , Health Services Accessibility/economics , Universal Health Insurance/economics , COVID-19/epidemiology , Developing Countries/economics , Humans , International Cooperation , Pandemics/economics , Public Health/economics
20.
J Am Board Fam Med ; 34(Suppl): S203-S209, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1100014

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic has laid bare the dis-integrated health care system in the United States. Decades of inattention and dwindling support for public health, coupled with declining access to primary care medical services have left many vulnerable communities without adequate COVID-19 response and recovery capacity. "Health is a Community Affair" is a 1966 effort to build and deploy local communities of solution that align public health, primary care, and community organizations to identify health care problem sheds, and activate local asset sheds. After decades of independent effort, the COVID-19 pandemic offers an opportunity to reunite and align the shared goals of public health and primary care. Imagine how different things might look if we had widely implemented the recommendations from the 1966 report? The ideas and concepts laid out in "Health is a Community Affair" still offer a COVID-19 response and recovery approach. By bringing public health and primary care together in community now, a future that includes a shared vision and combined effort may emerge.


Subject(s)
COVID-19/therapy , Delivery of Health Care, Integrated/organization & administration , Primary Health Care/standards , Public Health/standards , COVID-19/epidemiology , Cooperative Behavior , Delivery of Health Care, Integrated/trends , Humans , Pandemics , Primary Health Care/economics , Primary Health Care/trends , Public Health/economics , Public Health/trends , SARS-CoV-2 , United States/epidemiology
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