Economic shocks and public health protections in US metropolitan areas

G.P. Mays and R.A. Hogg

American Journal of Public Health, 2015, vol. 105, S280-S287

Abstract: Objectives: We examined public health system responses to economic shocks using longitudinal observations of public health activities implemented in US metropolitan areas from 1998 to 2012. Methods: The National Longitudinal Survey of Public Health Systems collected data on the implementation of 20 core public health activities in a nationally representative cohort of 280 metropolitan areas in 1998, 2006, and 2012. We used generalized estimating equations to estimate how local economic shocks relate to the scope of activities implemented in communities, the mix of organizations performing them, and perceptions of the effectiveness of activities. Results: Public health activities fell by nearly 5%in the average community between 2006 and 2012, with the bottom quintile of communities losing nearly 25%of their activities. Local public health delivery fell most sharply among communities experiencing the largest increases in unemployment and the largest reductions in governmental public health spending. Conclusions: Federal resources and private sector contributions failed to avert reductions in local public health protections during the recession. New financing mechanisms may be necessary to ensure equitable public health protections during economic downturns.

Keywords: economic recession; economics; human; longitudinal study; public health service; statistics and numerical data; urban population, Economic Recession; Humans; Longitudinal Studies; Public Health Administration; Public Health Practice; Urban Population (search for similar items in EconPapers)
Date: 2015
References: Add references at CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2014.302456

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302456_2

DOI: 10.2105/AJPH.2014.302456

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().