public health spending, public health economics, public health finance, public health financial analysis, public health funding



  1. Budetti, Peter P. MD, JD
  2. Lapolla, Michael MHA


All-state fiscal year 2005 public health-related spending in the state of Oklahoma was investigated including funds from federal, state, and local sources expended through the state health department and the two autonomous metropolitan health departments.


Methodology: The cost finding and allocation methodology used a series of structured resource worksheets developed for this project that segregate public health department expenditures into six primary groups: disease and prevention; family health; community health; protective health; support and administrative services; and other. The six primary groups were further divided into 59 units and subunits. All financial data were provided directly by staff in the public health agencies working closely with project staff. The data were analyzed along three lines: (1) level of health department (state, metro, other local); (2) revenue source (federal, state, local); and (3) public health function (behaviors, health conditions, direct services, population health).


Results and conclusions: Public health officials may not have necessary information on the multiple sources and applications of revenue, categories of expense, operational control of resources, and the inherent restrictions upon the use of those resources. The study gave the city-county and state health officials a new and more complete picture of public health spending in Oklahoma, which catalyzed a dialogue between the commissioner and the directors to explore ways for local priorities to be incorporated into the direct state spending.