Abstract
A self-administered survey was distributed to members of The Big Cities Health Coalition, a group of Health Officers/Commissioners from 17 of the largest US metropolitan health departments. The survey asked participants about their chronic disease priorities, data sources, budgets, and funding sources as well as examples of successful chronic disease interventions. Members of the Coalition discussed the survey results in a scheduled conference call. Chronic diseases account for 70% of all deaths nationwide on average, yet the health departments surveyed allocated an average of 1.85% of their budgets to chronic disease. Average chronic disease spending per inhabitant was $2.33, with a median of $1.56. Among the group’s top chronic disease priorities were asthma, diabetes, tobacco, cancer, and cardiovascular disease (CVD). Nearly half of the group’s chronic disease spending was on tobacco. Chronic disease funding sources varied across localities, but direct federal funding was minimal. In 14 cities serving a combined 37 million people (13% of the US population), direct federal chronic disease funding totaled $8.7 million, an average of $0.24 per capita. The group described successful chronic disease interventions, particularly related to tobacco and asthma.
Keywords: Chronic disease, Funding, Public health practice, Urban health
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Footnotes
The Big Cities Health Coalition members: John M. Auerbach, MBA (Boston Public Health Commission); Peter Beilenson, MD, MPH (Baltimore City Health Department); Matthew Carroll, AB, JD (Cleveland Department of Public Health); Mary DesVignes-Kendrick, MD, MPH (Houston Department of Health and Human Services); John F. Domzalski, JD, MPH (Philadelphia Department of Public Health); Franklin Judson, MD (Denver Public Health Department); Mitchell H. Katz, MD (San Francisco Department of Public Health); Alonzo Plough, PhD, MA, MPH (Seattle/King County Public Health); Eleni Sfakianaki, MD, MSPH (Miami-Dade County Health Department); Adewale Troutman, MD, MPH (Fulton County Department of Health and Wellness); Jonathan B. Weisbuch, MD, MPH (Maricopa County Department of Public Health); Judith West, MPH (Detroit Department of Health); John L., Wilhelm, MD, MPH (Chicago Department of Public Health); Steve Wilson, MD, MPH (Dallas County Department of Health and Human Services).
References
- 1.Centers for Disease Control and Prevention. The burden of chronic diseases and their risk factors: national and state perspectives 2002. Available at: http://www.cdc.gov/nccdphp/burdenbook2002/index.htm. Accessed July 2, 2003.
- 2.Toomey KE. Improving states’ capacity for chronic disease epidemiology: can state health officials meet the challenge? J Public Health Manag Pract. 2003;4:256–256. doi: 10.1097/00124784-200307000-00002. [DOI] [PubMed] [Google Scholar]
- 3.Koplan JP, Marks JS, McKenna MT, Taylor WR. Current issues and challenges in chronic disease control. In: Brownson RC, editor. Chronic Disease Epidemiology and Control. Washington, DC: American Public Health Association; 1998. pp. 1–26. [Google Scholar]
- 4.Centers for Disease Control and Prevention. Youth Risk Behavioral Surveillance System: 2001 results. Available at: http://www.cdc.gov/nccdphp/dash/yrbss/youth01online.htm. Accessed July 2, 2003.
- 5.U.S. Census Bureau Web site. 2000 Census US population of 281,421,906. Available at: http://www.census.gov/main/www/cen2000.html. Accessed July 2, 2003.
- 6.Niemeyer D, Miner KR, Carlson LM, Baer K, Shorty L. The 1998 master settlement agreement: a public health opportunity realized—or lost? Health Promot Pract. 2004;5:21S–32S. doi: 10.1177/1524839904264588. [DOI] [PubMed] [Google Scholar]
- 7.Centers for Disease Control and Prevention. FY 2004 Budget Request-Funding by Budget Activity. Available at: http://www.cdc.gov/fmo/FundingbyBudgetActivityTable.pdf. Accessed July 2, 2003.
- 8.Davis JR, Schwartz R, Wheeler F, Lancaster RB. Intervention methods for chronic disease control. In: Brownson RC, editor. Chronic Disease Epidemiology and Control. Washington, DC: American Public Health Association; 1998. pp. 77–116. [Google Scholar]
- 9.U.S. Department of Health and Human Services. Steps To A Healthier US Initiative Available at: http://www.healthierus.gov/steps/. Accessed July 2, 2003.
- 10.Hardy GE. The burden of chronic disease: the future is prevention. Prev Chronic Dis. 2004;1:1–2. [PMC free article] [PubMed] [Google Scholar]