Ohio public health one of the worst funded in the country, faces further cuts in state budget
A new analysis of state public health systems shows Ohio’s has some of the worst funding support in the nation, and that funding could go down even more in the newest state budget.
Using 2021 data from the State Health Access Data Assistance Center, the Health Policy Institute of Ohio found that the state spent $24 per person on public health, “far less than most other states.”
“Overall, Ohio’s investment in public health is lower than many other states at both the state and local levels,” the institute stated.
According to the data, only 12 states are worse than Ohio for state public health funding, with the worst being Missouri, at $6.54 per person in 2021. The highest ranked was the District of Columbia, at $370.56 in per-capita spending that year.
Public health involves everything from vaccine awareness and health education to food and water safety.
While health outcomes are influenced by clinical care like primary care check-ups, health behaviors and the social, economic, and physical environment make up a bigger part of the health outcome influences, according to policy briefs by the institute.
“Public health workers focus on stopping health problems before they start,” the HPIO stated in a recent policy brief. “For example, public health workers prevent injuries and deaths by providing parents with information about how to correctly install infant car seats, distributing drug overdose reversal medication and raising awareness of senior fall prevention programs.”
Other public health roles include nurses at school-based health centers, restaurant inspectors, public assistance program nutritionists, epidemiologists who look at health trends like infant mortality, and workers who conduct home visits as part of the Help Me Grow program.
That program, along with infant vitality programs are portions of the state budget that may see cuts, even as public health advocates ask the state to support the sector more than it already does.
In the Ohio House’s version of the state budget, $22.5 million would be cut from the Help Me Grow program in fiscal year 2027, representing a 26% reduction. Infant vitality programs would see cuts of more than $2 million each in 2026 and 2027, a nearly 10% cut. The programs, both housed under the Ohio Department of Children and Youth, are still awaiting final numbers, as the Ohio Senate takes up its budget discussions. A final draft will then be developed by both chambers, before it’s sent to the governor by July 1.
The House version of the budget leaves local health department support unchanged, with that support set at the same $2.379 million the line item received in 2024 and this year. State funding for infectious disease prevention and control within the Ohio Department of Health will also receive relatively the same amount of funding as it received in 2024, though the House version drops the budget slightly from the estimated 2025 funding. The 2025 estimate by the state has funding at $5.2 million, and the House set funding for 2026 and 2027 at $4.9 million per year.
In Ohio, 2023 annual financial reports from the Ohio Department of Health and the Association of Ohio Health Commissioners showed 72% of local health department revenue comes from the local level, including local government funds, public health levies in some areas and fees. Federal funding distributed by the state makes up 16% of the revenue, 6% is from other state sources, and 5% comes from direct federal funding to local departments. Local health departments only receive 1% of their revenue via state subsidy, according to the data.
The Health Policy Institute’s review of 2024 Ohio Department of Health data shows it receives half of its revenue from federal sources, 31% from the state and 19% came from the federal response to the COVID-19 pandemic.
With $979 million in state fiscal year 2024, the state used that revenue almost equally across three topics: disease prevention, implementation of the federal Women, Infant and Children (WIC) program, and services related to COVID-19 and other infectious diseases, according to an HPIO policy brief on public health basics. These three topics each took 22% to 23% in ODH expenditures.
Another 11% went to family and community health services, 6% went to maternal and infant vitality, 5% to administrative services, 4% to “quality assurance” for long-term care facilities, 4% for public health preparedness information and 2% for “other family and community health services” passed through local health districts.
Public health initiatives yield an average return on investment of $14 for every dollar spent, through improved health outcomes, reduced health care costs and increased productivity, according to the institute’s public health analysis.
Among other policy recommendations, the instituted urged continued or even increased support for the federal Public Health Infrastructure Grant would be important to “strengthen the public health workforce, foundational capabilities and data systems through the end of 2027.”
The public health sector has faced struggles like high turnover, high burnout rates in existing employees and a lack of adequate pay.
“Consistent delivery of these services across the state depends upon an adequate public health workforce,” the HPIO stated.