The U.S. financial crisis has affected every part of the federal budget with a special focus on state and local budgets. Spending has been cut almost across the board when it comes to state and local issues, and federal subsidies have been available but spread thin. While public health has been as much on the chopping block as any other sector of the states’ budgets, many have reduced spending in other areas in order to sustain health programs, while some have even increased spending in this area because of its vital importance to the American people.

Two organizations joined forces, as they have done for seven years, to study data relating to public health and disease preparedness. Trust for America’s Health and The Robert Wood Johnson Foundation, both nonprofits dedicated to the health and wellness of the American public, recently published the 2009 edition of “Ready or Not? Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism.” While the research examined a broad spectrum of issues relating to public health and preparedness, one of the sections focused on the commitment of all 50 states and the District of Columbia to public health funding.

The report looked at data regarding public health programs, specifically the infrastructure of such programs as able to respond to public health emergencies, and the information was taken from the fiscal year 2008 to 2009. By studying each state’s budget and adjusting according to inflation, it was determined how states have allocated their public health funding and increased or decreased it based on needs and federal requirements.

Though there are budget cuts in 41 states, only 27 of them allowed those cuts to curtail public health spending, while the others tried to stay level or even increase funding to that area of the budget. Of those 27 states, Arizona made the most serious decrease by cutting public health by 24.5 percent, and South Carolina was not far behind with a 22 percent decrease. Several others came in at over 10 percent, including California, Florida, Indiana, Mississippi, and North Carolina, while Hawaii made less than a one percent cut in such spending.

There were 23 states and the District of Columbia that actually increased funds allocated to public health, and North Dakota showed the highest percentage with a 25.5 percent increase. Washington, D.C. came in second with 18.5 percent, and eight more states came in at over 10 percent.

The study did note, though, that the numbers given do not reflect if the amounts of funding dedicated to public health are actually sufficient to cover the states’ needs. Hospital funding was also a separate category and not included in public health spending. In addition, the continuing economic downturn in the U.S. may cause more budget cuts - $166 billion in 2010 and $350 billion in 2011, according to the Center on Budget and Policy Priorities - which could have a negative effect on future budget decisions regarding public health and emergency preparedness.

As the report stated, “With the current recession, states are in severe economic distress and many states have tried to close shortfalls by increasing taxes and/or cutting spending.” The prognosis for 2010 and subsequent years is not positive, so strides made by states through 2009 may not continue as budgets are squeezed tighter and money simply is not available to prepare for possible emergencies when the current condition is so dire.