Local Health Departments' Spending on the Foundational Capabilities

Simone R. Singh, Betty Bekemeier, Jonathon P. Leider

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Improving our nation's public health system requires a detailed understanding of public health expenditures and related revenue sources, yet no comprehensive data source exists that contains such information for governmental health agencies at all levels. Using pilot study data of a standardized financial accounting framework for public health agencies - in the form of a uniform chart of accounts crosswalk - this article presents local health departments' (LHDs') expenditures on the foundational capabilities, that is, crosscutting skills and capacities needed to support all of an LHD's programs and activities. Among 16 sample LHDs from 4 states, per capita foundational capabilities spending ranged from $1.10 to $26.19, with a median of $7.67. Larger LHDs and LHDs with greater financial resources spent more per capita, as did accredited LHDs. Future work using data from a larger sample of LHDs is needed to examine agency and community-level characteristics associated with adequate funding for the foundational capabilities.

Original languageEnglish (US)
Pages (from-to)52-56
Number of pages5
JournalJournal of Public Health Management and Practice
Issue number1
StatePublished - Jan 1 2020

Bibliographical note

Funding Information:
This study was supported by grant no. 73187 from the Robert Wood Johnson Foundation. The authors gratefully acknowledge the enthusiasm, wisdom, and practical expertise brought to this project by the leaders and staff of their study’s 20 participating health departments.

Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.


  • foundational capabilitiess
  • Local Health Departments
  • public health expenditure

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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