Healthcare Funding

Hawaii spends more money on public health per person than any other state, according to a new study released by the nonprofit Trust for America's Health.

"Hawaii is good," Jeffrey Levi, executive director of the organization and one of the report's authors, said in a telephone interview. "Public health is a priority in the state, at least with the state Legislature."

Hawaii led the nation with the highest state public health funding per person in the last fiscal year -- a total of nearly $196 million -- an average of about $152.66 per person, the report said.

But that figure reflects funding only for certain programs the Trust for America's Health is interested in, said state Health Director Chiyome Fukino. The state general fund budget for the Health Department totaled $397.4 million last year for all services.

It is a big budget based on the state's small population because certain infrastructure is needed to run health services throughout the islands, and there are no county health departments, she said. "It doesn't mean we have everything we need or are the best equipped of all states in terms of public health services."

The 50th State ranks 13th among states for federal funding from the U.S. Centers for Disease Control and Prevention based on figures for the 2007 federal fiscal year, ending in September, it said.

The analysis, "Shortchanging America's Health: A State-by-State Look at How Federal Public Health Dollars Are Spent -- 2008," shows how much money states are receiving and spending for public health.

"One of the concerns we have is the relatively low money spent for prevention," Levi said. "We're investing a lot of money in health care and not enough in prevention and health."

He said this is reflected in CDC funding, which has declined in the past four years for prevention activities.

The authors of the study said it is easier to compare federal investments across states than state spending from one to another, Fukino noted.

There are many issues to consider, she said, such as population size, different structures, public health services and budget reporting methods. "It's like apples and oranges."

Hawaii's CDC funding totaled about $34 million in the 2007 federal fiscal year -- $26.45 per person, compared with a national average of $17.23 per person.

Hawaii also did well in two other areas, Levi noted.

The state ranked third in the nation with nearly $41.7 million in federal funding, $32.53 per person, from the Health Resources and Services Administration. This includes money for community health centers and programs such as HIV/AIDS under the Ryan White CARE Act.

Federal funding of $2.1 million, or $1.66 per person, for the hospital preparedness program put Hawaii in ninth place nationally. Hawaii had a perfect score of 10 for emergency preparedness indicators in 2007.

Hawaii ranked 49th in the nation with a low 8.8 percent of population who are uninsured.

But the state did not fare well in all areas.

It had the nation's highest asthma rate of 30.4 percent among high school students in 2005. It was fourth for adult asthma rates of 14.6 percent, a 2004-2006 average.

Among public health indicators, the study looked at shortage areas of health professionals in fiscal 2007. Hawaii placed 23rd in the nation with an estimated shortage of 4,500 nurses by 2010. It was among states with the lowest shortage rates for primary care, mental health and dental care professionals.


Isles rank 13th for CDC Funding
State rankings for funding from Centers for Disease Control per capita:
1. Alaska $69.76
2. Georgia $52.56
3. Maryland $49.35
13. Hawaii $26.45
48. Florida $14.06
49. Indiana $13.69
50. Kansas $13.61
Source:Hawaii spends more money on public health per person than any other state, according to a new study released by the nonprofit Trust for America's Health.

"Hawaii is good," Jeffrey Levi, executive director of the organization and one of the report's authors, said in a telephone interview. "Public health is a priority in the state, at least with the state Legislature."

Hawaii led the nation with the highest state public health funding per person in the last fiscal year -- a total of nearly $196 million -- an average of about $152.66 per person, the report said.

But that figure reflects funding only for certain programs the Trust for America's Health is interested in, said state Health Director Chiyome Fukino. The state general fund budget for the Health Department totaled $397.4 million last year for all services.

It is a big budget based on the state's small population because certain infrastructure is needed to run health services throughout the islands, and there are no county health departments, she said. "It doesn't mean we have everything we need or are the best equipped of all states in terms of public health services."

The 50th State ranks 13th among states for federal funding from the U.S. Centers for Disease Control and Prevention based on figures for the 2007 federal fiscal year, ending in September, it said.

The analysis, "Shortchanging America's Health: A State-by-State Look at How Federal Public Health Dollars Are Spent -- 2008," shows how much money states are receiving and spending for public health.

"One of the concerns we have is the relatively low money spent for prevention," Levi said. "We're investing a lot of money in health care and not enough in prevention and health."

He said this is reflected in CDC funding, which has declined in the past four years for prevention activities.

The authors of the study said it is easier to compare federal investments across states than state spending from one to another, Fukino noted.

There are many issues to consider, she said, such as population size, different structures, public health services and budget reporting methods. "It's like apples and oranges."

Hawaii's CDC funding totaled about $34 million in the 2007 federal fiscal year -- $26.45 per person, compared with a national average of $17.23 per person.

Hawaii also did well in two other areas, Levi noted.

The state ranked third in the nation with nearly $41.7 million in federal funding, $32.53 per person, from the Health Resources and Services Administration. This includes money for community health centers and programs such as HIV/AIDS under the Ryan White CARE Act.

Federal funding of $2.1 million, or $1.66 per person, for the hospital preparedness program put Hawaii in ninth place nationally. Hawaii had a perfect score of 10 for emergency preparedness indicators in 2007.

Hawaii ranked 49th in the nation with a low 8.8 percent of population who are uninsured.

But the state did not fare well in all areas.

It had the nation's highest asthma rate of 30.4 percent among high school students in 2005. It was fourth for adult asthma rates of 14.6 percent, a 2004-2006 average.

Among public health indicators, the study looked at shortage areas of health professionals in fiscal 2007. Hawaii placed 23rd in the nation with an estimated shortage of 4,500 nurses by 2010. It was among states with the lowest shortage rates for primary care, mental health and dental care professionals.


Isles rank 13th for CDC Funding
State rankings for funding from Centers for Disease Control per capita:
1. Alaska $69.76
2. Georgia $52.56
3. Maryland $49.35
13. Hawaii $26.45
48. Florida $14.06
49. Indiana $13.69
50. Kansas $13.61
Source:http://starbulletin.com/2008/04/03/news/story08.html