Variation In Health Outcomes: The Role Of Spending On Social Services, Public Health, And Health Care, 2000–09

• DOI: 10.1377/hlthaff.2015.0814
• Publication Date: 2016-05-02T19:27:25Z
• Authors: Elizabeth H. Bradley; Maureen Canavan; Erika Rogan; Kristina Talbert-...; Chima Ndumele; Lauren Taylor; Leslie A. Curry
• Keywords: Social Work; Medicaid; 1. No poverty; Medicare; United States; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Chronic Disease; Outcome Assessment, Health Care; Humans; Longitudinal Studies; Public Health; Health Expenditures; Delivery of Health Care; Retrospective Studies

Although spending rates on health care and social services vary substantially across the states, little is known about possible association between variation in state-level outcomes allocation of state services. To estimate that association, we used repeated measures multivariable modeling for period 2000-09, with region time fixed effects adjusted total demographic economic characteristics one- two-year lags. We found states a higher ratio to (calculated as sum service public divided by Medicare Medicaid spending) had significantly better subsequent following seven measures: adult obesity; asthma; mentally unhealthy days; days activity limitations; mortality lung cancer, acute myocardial infarction, type 2 diabetes. Our study suggests broadening debate beyond what should be spent include invested health-not only but also health-is warranted.