Trust for America’s Health (TFAH) has released the 2023 Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations. The Fact Sheets for all fifty states and the District of Columbia are available here.

This report acknowledges some of the public health triumphs of the United states, including breakthroughs in vaccinations against deadly diseases, the Clean Air Act of 1963, and nutrition and healthy lifestyle initiatives that have been brought into the forefront. However, the authors conclude that for over 20 years, the U.S. public health system has lacked adequate and predictable funding to support the needs of public health. This challenge was exacerbated by the COVID-19 pandemic, a health crisis that tested the limits of the public health infrastructure and emergency response. This, along with behavioral health crises and health disparities among marginalized communities, highlight the need for TFAH’s recommendations.

This report is divided into two main sections: The first section addresses Public Health Funding Trends in Federal, State and Local funding. The second section contains Recommended Policy Actions to Modernize and Strengthen Public Health in Every Community, Invest in the Nation’s Health Security, Address Health Disparities and Root Causes of Disease, Safeguard and Improve Health Across the Lifespan, and Invest in Primary Prevention of Behavioral Health Concerns and Deaths of Despair. TFAH recommends that Congress and the president take these actions for FY 2024 and beyond.

For more information, check out HSDL’s In Focus topic on Disaster Economics.