The Importance of Governmental and Nongovernmental Investments in Public Health and Social Services for Improving Community Health Outcomes

Jeffrey McCullough, Simone R. Singh, Jonathon P. Leider

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVE: To explore whether health outcomes are influenced by both governmental social services spending and hospital provision of community health services. DESIGN: We combined hospital provision of community health services data from the American Hospital Association with local governmental spending data from the US Census Bureau. Longitudinal models regressed community health outcomes for 2012-2016 on local government spending on health, social services, and education from 5 years previously, controlling for sociodemographic and hospital marketplace characteristics, spatial autocorrelation, and state-level random effects. For counties with hospitals, models also included county-level data on hospitals' provision of community health services. SETTING: All analyses were performed at the county level for US counties between 2012 and 2016. PARTICIPANTS: Complete spending, hospital, and health outcomes data were available for a total of 2379 counties. MAIN OUTCOME MEASURES: We examined relationships between governmental spending, hospital service provision, and 5 population health outcome measures: years of potential life lost prior to age 75 years per 100 000 population, percentage of population in fair or poor health, percentage of adults who are physically inactive, deaths due to injury per 100 000 population, and percentage of births that are of low birth weight. RESULTS: Governmental investments in health, social services, and education positively impacted key health outcomes but mainly in counties with 1 or more hospitals present. Hospitals' provision of community health services also had a significant positive impact on health outcomes. CONCLUSIONS: Hospital provision of community health services and increases in local governmental health and social services spending were both associated with improved health. Collaboration between local governments and hospitals may help ensure that public and private community health resources synergistically contribute to the public's health. Local policy makers should consider service provision by the private sector to leverage the public investments in health and social services.

Original languageEnglish (US)
Pages (from-to)348-356
Number of pages9
JournalJournal of public health management and practice : JPHMP
Volume25
Issue number4
DOIs
StatePublished - Jul 1 2019

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United States Public Health Service
Social Work
Community Health Services
Health
Health Services
Local Government
Health Education
Population
American Hospital Association
County Hospitals
Spatial Analysis
Private Sector
Health Resources
Low Birth Weight Infant
Censuses
Life Expectancy
Administrative Personnel
Public Health
Outcome Assessment (Health Care)
Parturition

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

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title = "The Importance of Governmental and Nongovernmental Investments in Public Health and Social Services for Improving Community Health Outcomes",
abstract = "OBJECTIVE: To explore whether health outcomes are influenced by both governmental social services spending and hospital provision of community health services. DESIGN: We combined hospital provision of community health services data from the American Hospital Association with local governmental spending data from the US Census Bureau. Longitudinal models regressed community health outcomes for 2012-2016 on local government spending on health, social services, and education from 5 years previously, controlling for sociodemographic and hospital marketplace characteristics, spatial autocorrelation, and state-level random effects. For counties with hospitals, models also included county-level data on hospitals' provision of community health services. SETTING: All analyses were performed at the county level for US counties between 2012 and 2016. PARTICIPANTS: Complete spending, hospital, and health outcomes data were available for a total of 2379 counties. MAIN OUTCOME MEASURES: We examined relationships between governmental spending, hospital service provision, and 5 population health outcome measures: years of potential life lost prior to age 75 years per 100 000 population, percentage of population in fair or poor health, percentage of adults who are physically inactive, deaths due to injury per 100 000 population, and percentage of births that are of low birth weight. RESULTS: Governmental investments in health, social services, and education positively impacted key health outcomes but mainly in counties with 1 or more hospitals present. Hospitals' provision of community health services also had a significant positive impact on health outcomes. CONCLUSIONS: Hospital provision of community health services and increases in local governmental health and social services spending were both associated with improved health. Collaboration between local governments and hospitals may help ensure that public and private community health resources synergistically contribute to the public's health. Local policy makers should consider service provision by the private sector to leverage the public investments in health and social services.",
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N2 - OBJECTIVE: To explore whether health outcomes are influenced by both governmental social services spending and hospital provision of community health services. DESIGN: We combined hospital provision of community health services data from the American Hospital Association with local governmental spending data from the US Census Bureau. Longitudinal models regressed community health outcomes for 2012-2016 on local government spending on health, social services, and education from 5 years previously, controlling for sociodemographic and hospital marketplace characteristics, spatial autocorrelation, and state-level random effects. For counties with hospitals, models also included county-level data on hospitals' provision of community health services. SETTING: All analyses were performed at the county level for US counties between 2012 and 2016. PARTICIPANTS: Complete spending, hospital, and health outcomes data were available for a total of 2379 counties. MAIN OUTCOME MEASURES: We examined relationships between governmental spending, hospital service provision, and 5 population health outcome measures: years of potential life lost prior to age 75 years per 100 000 population, percentage of population in fair or poor health, percentage of adults who are physically inactive, deaths due to injury per 100 000 population, and percentage of births that are of low birth weight. RESULTS: Governmental investments in health, social services, and education positively impacted key health outcomes but mainly in counties with 1 or more hospitals present. Hospitals' provision of community health services also had a significant positive impact on health outcomes. CONCLUSIONS: Hospital provision of community health services and increases in local governmental health and social services spending were both associated with improved health. Collaboration between local governments and hospitals may help ensure that public and private community health resources synergistically contribute to the public's health. Local policy makers should consider service provision by the private sector to leverage the public investments in health and social services.

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