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  1. Orr, Jason M. MPH
  2. Leider, Jonathon P. PhD
  3. Singh, Simone PhD
  4. Balio, Casey P. BA
  5. Yeager, Valerie A. DrPH
  6. Bekemeier, Betty PhD, MPH, FAAN
  7. McCullough, J. Mac PhD
  8. Resnick, Beth DrPH


Context: Governments at all levels work to ensure a healthy public, yet financing, organization, and delivery of public health services differ across the United States. A 2012 Institute of Medicine Finance report provided a series of recommendations to ensure a high-performing and adequately funded public health infrastructure.


Objectives: This review examines the influence of the Finance report's 10 recommendations on public health policy and practice.


Design: This review utilized peer-reviewed and gray literature published since 2012.


Eligibility Criteria: Documents that address at least one of the Finance report's 10 recommendations and contain information on either official actions taken in response to the Finance report or evidence of the report's influence on the practice community.


Results: Of 2394 unique documents found, a total of 56 documents met the eligibility criteria. Review of these 56 documents indicated that the most substantial activity related to the recommendations was focused on the "minimum package of public health services" concept and establishment of a uniform chart of accounts.


Discussion: Progress has been mixed on the Finance report recommendations. Improved tracking and auditing of public health activity appears to be advancing, yet financial benchmarks remain unmet. Challenges remain in determining actual investment in public health and equitable resource allocation approaches. State and local health department use of cost estimation methodology and a uniform chart of accounts tool has contributed to an increase in understanding and improvement in public health spending.


Conclusions: The Finance report has served as a strong impetus for advocating for an increased investment in governmental public health. Efforts are bolstered by informed public health practitioners and stakeholders but often stymied by policy makers who must balance complex competing issues and priorities. Although many successes have occurred, further work is needed toward improving investment in the nation's public health.