ISSUE REPORT Shortchanging America’s Health ‘09 A STATE-BY-STATE LOOK AT HOW FEDERAL PUBLIC HEALTH DOLLARS ARE SPENT AND KEY STATE HEALTH FACTS MARCH 2009 PREVENTING EPIDEMICS. PROTECTING PEOPLE. TRUST FOR AMERICA’S HEALTH The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to IS A NON-PROFIT, NON-PARTISAN improving the health and health care of all Americans, the Foundation works with a diverse ORGANIZATION DEDICATED TO group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought SAVING LIVES AND MAKING experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and DISEASE PREVENTION A get the care they need—the Foundation expects to make a difference in our lifetime. For NATIONAL PRIORITY. more information, visit www.rwjf.org. TFAH BOARD OF DIRECTORS REPORT AUTHORS ACKNOWLEDGEMENTS Lowell Weicker, Jr. Jeffrey Levi, PhD. This report is supported by a grant from the President Executive Director Robert Wood Johnson Foundation. The Former 3-term U.S. Senator and Trust for America’s Health opinions expressed in this report are those Governor of Connecticut and of the authors and do not necessary reflect Associate Professor in the Department the views of the foundation. Cynthia M. Harris, PhD, DABT of Health Policy Vice President The George Washington University Director and Associate Professor PEER REVIEWERS School of Public Health and Health Institute of Public Health, Florida Services TFAH thanks the reviewers for their time, A&M University Rebecca St. Laurent, JD expertise, and insights. The opinions ex- Margaret A. Hamburg, MD pressed in this report do not necessarily rep- Health Policy Research Assistant Secretary resent the views of these individuals or their Trust for America’s Health Senior Scientist organizations. Nuclear Threat Initiative (NTI) Laura M. Segal, MA Director of Public Affairs Marcia S. Mabee, MPH, PhD Patricia Baumann, MS, JD Executive Director Trust for America’s Health Treasurer Coalition for Health Funding President and CEO Serena Vinter, MHS Bauman Foundation Senior Research Associate Robert M. Pestronk, MPH Trust for America’s Health Executive Director Gail Christopher, DN National Association of County and Vice President for Health City Health Officials WK Kellogg Foundation John W. Everets David Fleming, MD Director of Public Health Seattle King County, Washington Arthur Garson, Jr., MD, MPH Executive Vice President and Provost and the Robert C. Taylor Professor of Health Science and Public Policy University of Virginia Robert T. Harris, MD Former Chief Medical Officer and Senior Vice President for Healthcare BlueCross BlueShield of North Carolina Alonzo Plough, MA, MPH, PhD Director, Emergency Preparedness and Re- sponse Program Los Angeles County Department of Public Health Theodore Spencer Project Manager Natural Resources Defense Council Introduction E very American should have the opportunity to be as healthy as he or she can be. Every community should be safe from threats to its health. Protecting the health and safety of Americans should be a top responsibility of our nation’s leaders. Currently, serious gaps exist in the nation’s billion annually -- across state, local, and federal ability to safeguard health, and with the cur- government -- in funding for critical U.S. pub- rent state of the economy, these gaps will lic health programs, according to an analysis by only get worse, putting our families, com- The New York Academy of Medicine (NYAM) munities, states, and nation at risk. The and Trust for America’s Health (TFAH), con- country does not devote the resources ducted in consultation with a panel of leading needed to adequately help prevent disease experts in 2008.2 The analysis found that fed- and protect the health of Americans. eral, state, and local public health departments have been unable to adequately carry out many The nation spends more than $2 trillion annu- core functions, including programs to help ally on health care, more than any other nation prevent disease and prepare for health emer- in the world, but still tens of millions of Ameri- gencies. Approximately $1 billion of this short- cans suffer every day from chronic diseases like fall is due to cuts to the U.S. Centers for Disease cancer, diabetes, and Alzheimer’s, and prevent- Control and Prevention (CDC) budget over able infectious diseases that rob them of their the past five years. health and quality of life.1 Experts believe many of these diseases could be prevented through In this report, TFAH examines how much better public health measures, such as encour- the federal government spends to try to keep aging people to make healthier choices and the country well. A state-by-state review of fis- building healthier communities. cal year 2008 spending reveals that federal funding (through CDC) for public health Quality, affordable health care is essential, varies, often significantly, with a per capita but a strong public health system focused on low of $12.74 to a per capita high of $52.78. prevention must also be part of the solution. The national average is $17.60 per person, a The health crisis calls for urgent action by fraction of what is spent on health care costs. putting prevention at the center of the na- tion’s health strategy. The report also examines state funding for public health. Each state allocates and re- Health care has focused for too long on caring ports its budget in a different way. States also for people after they become sick or harmed in- vary widely in the level of specific detail they stead of trying to prevent disease. Prevention provide, which makes comparisons across means improving the quality of people’s lives, states a challenge. This analysis looks at ways sparing individuals from needless suffering, and to begin comparing budgets across states, eliminating unnecessary costs from the health and how increased transparency and ac- system. Helping people to be healthier is one of countability could help create an under- the best ways to keep health care costs down. standing of how spending on public health The nation’s public health system is responsi- programs can have a positive impact on peo- ble for improving the health of Americans. ple’s health. The median state spending on However, the public health system has been public health is $33.71 per person, with a chronically underfunded in the United States range of $3.37 per person in Nevada to for decades. There has been a shortfall of $20 $172.21 per person in Hawaii. 1 To demonstrate the variation in health across in Colorado to a high of 31.7 percent in Mis- states, this report examines a sample of key sissippi, and rates of uninsured adults range health indicators in each state. For instance, from a low of 5.4 percent in Massachusetts to an examination of state data finds that adult a high of 25.2 percent in Texas. obesity rates range from a low of 18.4 percent 2 The Need to Increase Funding for Public Health Public Health and the Economic Stimulus The American Recovery and Reinvestment Act programs need to be funded at an adequate 1 SECTION provides an unprecedented level of increased level to have a significant and long-lasting im- investment toward revitalizing and modern- pact. Providing an ongoing funding for pub- izing the public health system. lic health and prevention must be a central part of health care reform. Funding public health programs is essential to improving the health and the productivity Adequately funding public health would re- of the nation’s workforce as well as contain- quire a total of $55 to $60 billion annually ing skyrocketing costs of health care. ($187 per person), according to the analysis by NYAM and TFAH. Based on the current Getting health care costs under control is criti- funding model, the federal government cal for getting the country’s economy back on should provide 60 percent of this increase track. Investing now in public health will make ($12 billion more than fiscal year (FY) 2005 Americans healthier as we move to a universal, dollars) and state and local governments reformed health care system. Fundamental should provide 40 percent of this increase ($8 health care reform, particularly reform that fo- billion annually). Clearly during this time of cuses on ways to keep Americans healthier, is a economic turmoil, it will be particularly diffi- crucial part of solving our current financial cri- cult for states and localities to contribute ad- sis. The funding for public health and disease ditional funding. However, funding strategies prevention in the stimulus package is a down can be developed now to be put in place once payment toward reducing health care costs. the economy begins to turn around. Options The funding in the stimulus package greatly that do not require spending but include rev- expands the federal investment in commu- enue raising taxes, such as tobacco and un- nity-level prevention, specifically programs healthy snack taxes should be examined. that impact health outside of the doctor’s of- It is important to note that over the past five fice that are evidence based and cost effec- years, federal funding for public health has tive. The new and expanded programs in the not kept pace with inflation. To simply re- stimulus bill also require transparency, strict verse the funding cuts of the past five years, evaluation, and accountability, so Americans Congress will need to restore $2.58 billion to can see how their tax dollars are being in- key public health agencies. vested in a way that is having a direct impact on improving the health of communities. Long-term strategies for restoring and in- creasing federal support for public health While the stimulus funding is significant, it could come from new revenue streams is only a one-time investment. A long-term, and/or from reviewing existing revenue permanent solution is needed to provide sus- streams. Some strategies could include tap- tained resources for public health programs. ping Medicare, Medicaid, and private payers, To realize the full potential return on the in- as well as public health dollars. vestment of keeping people healthy, these 3 “ LET’S BE CLEAR, IF WE WANT TO OVERCOME OUR ECONOMIC CHALLENGE, WE MUST OVERCOME OUR HEALTH CARE CHALLENGE.”3 “BECAUSE WE KNOW THAT SPIRALING HEALTH CARE COSTS ARE CRUSHING FAMILIES AND BUSINESSES ALIKE, WE’RE TAKING THE MOST MEANINGFUL STEPS IN YEARS TOWARDS MODERNIZING OUR HEALTH CARE SYSTEM. ...[T]HANKS TO THE ACTIONS WE’VE TAKEN, SEVEN MILLION AMERICANS WHO LOST THEIR HEALTH CARE ALONG THE WAY WILL CONTINUE TO GET THE COVERAGE THEY NEED, AND ROUGHLY 20 MILLION MORE AMERICANS CAN BREATHE A LITTLE EASIER KNOWING THAT THEIR HEALTH CARE WON’T BE CUT DUE TO A STATE BUDGET SHORTFALL. AND A HISTORIC COMMITMENT TO WELLNESS INITIATIVES WILL KEEP MILLIONS OF AMERICANS FROM SETTING FOOT IN THE DOCTOR’S OFFICE IN THE FIRST PLACE -- BECAUSE THESE ARE PREVENTABLE DISEASES AND WE’RE GOING TO INVEST IN PREVENTION. ” 4 -- PRESIDENT BARACK OBAMA Public Health and Health Reform In order to control health care costs and im- public health system and public policies fo- prove health, disease prevention must be a cused on prevention of disease and injury cornerstone of health care reform. must also be part of the solution. Health insurance and quality care are needed Prevention provides opportunities to help peo- to give all Americans the opportunity to be as ple from getting sick in the first place, or to healthy as they can be, but that is not enough. contain a health problem before it gets worse, The government must also create strategies to both inside and outside the doctor’s office. improve the health of all Americans. A strong Prevention Outside the Doctor’s Office: According to CDC, the majority of chronic I Providing access to fresh produce through diseases could be prevented through lifestyle famers markets; and environmental changes. While individ- I Making nutritious foods more affordable ual choices are an important part of staying and accessible to low-income areas; healthy, research has also shown that many factors beyond individual control contribute I Requiring clear calorie and nutrition la- to how healthy a person is. People do not beling of foods; make decisions in vacuums. For instance, fac- I Providing young mothers with information tors like the high costs of healthy foods, the about how to make good choices about nu- location of grocery stores, and access to safe trition; places to exercise can limit the choices peo- ple make. Community prevention programs I Offering counseling and proven pharma- help to make healthy choices easier choices. cological treatments for people trying to quit smoking and other tobacco use; and Examples of these types of programs include: I Raising taxes on cigarettes and other to- I Keeping schools open after hours so chil- bacco products. dren can play with adult supervision; 4 According to an analysis by the Urban Institute, ods. Community-based prevention programs these programs by definition do not increase can also have “spillover effects on the quality of health care costs and have been shown to re- life and economic vitality” in communities.5 duce health spending within short time peri- RETURN ON INVESTMENT Keeping people healthier is one of the most effective ways to reduce health care costs. A study developed through a partnership of TFAH, The Urban Institute, NYAM, the Robert Wood Johnson Foundation (RWJF), The California Endowment (TCE), and Prevention Institute, examines how much the country could save in health care costs if we invested more in disease prevention, specifically by funding proven community-based programs that result in increased levels of physical activity, improved nutrition (both quality and quantity of food), and a reduction in smoking and other tobacco use rates. TFAH’s analysis concludes that an investment of $10 per person per year in proven community- based disease prevention programs could yield net savings of more than $2.8 billion annually in health care costs in one to two years, more than $16 billion annually within five years, and nearly $18 billion annually in 10 to 20 years (in 2004 dollars). With this level of investment, the country could recoup nearly $1 over and above the cost of the program for every $1 invested in the first one to two years of these programs, a return on investment (ROI) of 0.96. Within five years, the ROI could rise to 5.6 for every $1 invested and rise to 6.2 within 10 to 20 years. This return on investment represents medical cost savings only and does not include the significant gains that could be achieved in worker productivity, reduced absenteeism at work and school, and enhanced quality of life. The researchers built the model to yield conservative estimates for savings, using low-end as- sumptions for the impact of programs on disease rates and high-end assumptions for the costs. Prevention Inside the Doctor’s Office Yet even people with quality insurance often less likely to seek non-emergency care, in- do not receive adequate preventive care. It is cluding preventive care. nearly impossible for people without health care Yet people with quality insurance also often do or who are underinsured to access preventive not receive adequate preventive care. Since care. Clinical prevention is often aimed at the current system is focused on treating con- early detection and treatment of disease so ditions once they arise, millions of Americans that its progression can be slowed or pre- develop chronic conditions that could have vented, or providing education about ways to been prevented with improved care. make healthy choices to help individuals from becoming ill in the first place. Examples of clinically-based prevention efforts include: Numerous studies show that without access to quality care, health suffers.6, 7, 8 Typically, I Immunizations; people without insurance do not receive ap- I Screening for breast, colon, cervical, and propriate care, including preventive care other many other forms of cancer; that could help spare them from diseases or I Screening for diabetes, heart disease, high control or treat on-going conditions. As a re- cholesterol, and high blood pressure; and sult, their health often deteriorates faster I Weight management counseling. than those receiving care, which leads to them needing more expensive emergency Increasing preventive care services to ensure treatment in the long run. During the eco- that every American has access to a core set nomic downturn, more individuals and fam- of proven services could help save significant ilies are losing coverage or are experiencing health care costs and help prevent people reductions in coverage, leaving them even from developing avoidable conditions.9 5 INVESTMENT IN A HEALTHIER AMERICA Long term potential revenue streams for increased funds for public health could include: Existing Funding Streams and Public Health Programs: Federal Level I Wellness Trust: The Brookings Institute’s Hamilton Project’s proposal for a Wellness Trust is one potential model for establishing a revenue stream to support clinical and community- based prevention.10, 11 The Wellness Trust would ensure every American has access to a core set of proven preventive care services, including immunizations and clinical prevention, screenings, and health counseling. The Trust would become the primary payer for these services for all Americans, and it would also have the authority to provide funding for infra- structure improvements. Support for the Wellness Trust would come from federally-funded health agencies and private insurers determining their spending and resulting savings from preventive services. The amount the federal government spends on priority prevention services would determine the budget authorization for the Wellness Trust. Funding would come from general revenue, in a process similar to how Medicare is funded, and would in- crease annually by the estimated projected growth in national health expenditures. I Medicare: Medicare has a direct interest in assuring a healthier aging population. If Ameri- cans are healthier when they reach the age of 65, it could save Medicare billions of dollars. An enhancement of preventive care services -- for people both under and over the age of 65 -- is long overdue, and this would require a change in policy regarding the appropriate target of Medicare-funded initiatives and two very different approaches could be taken. L Tapping a percentage of Medicare spending and allocating those resources to fund public health programs. Medicare would more than likely recoup the investment in future savings. L Creating a “prevention initiatives” demonstration pilot program with direct support from the Centers for Medicare and Medicaid Services (CMS). One example of how Congress could create a new structure is by creating a Healthy Living, Healthy Aging pilot program for pre-Medicare-eligible Americans to invest in proven community-based disease pre- vention programs to help prevent disease and promote better health for Americans under the age of 65, potentially focusing on individuals between 55 and 64 years old. This in- vestment would show a return in savings for Medicare, since it would reduce the rates of disease and keep people healthier as they age. I Medicaid: If preventive efforts can help stop some people from developing disabilities, this could also prevent these individuals from becoming Medicaid eligible, which would create additional cost savings. Policy changes would be needed to permit financing community- level prevention services under Medicaid, but this would ensure an increased investment by both the federal and state governments. Approaches similar to those outlined for Medicare should be considered. L Tapping a percentage of federal Medicaid spending (with a required state match) would create substantial new resources for public health programs. L Creating demonstration or pilot programs similar to the Medicare program above to help resolve issues of who is a Medicaid provider and how reimbursement can be handled. L Setting up Medicaid Administrative Accounts. States currently use federal Medicaid matching funds to reimburse a portion of administrative costs. This reimbursement effec- tively underwrites many state and local health programs. Some states are already using some of this funding to support public health and prevention-related programs. Addi- tional states could consider this approach to designate this matching amount to support prevention-related programs. 6 Supporting State Initiatives. On average, states and localities provide about 40 percent of revenues for public health programs. I Create a matching requirement for grantees receiving increased federal funding: There is a wide variation in the level of investment by states and localities in public health. States and localities would be required to provide a match to receive new federal money, reflecting the 60 percent federal and 40 percent state-local investment that currently exist. Such a requirement could be suspended during an economic recession. I State- or Community-Level Equivalent of the Wellness Trust: The federal govern- ment could provide seed money for the formation of a public-private partnership agency at the state- or community-level modeled on a national Wellness Trust. Possible Options for New Revenue Streams I Surcharges on Health Care Funding Mechanisms: Private insurers, not just Medicare and Medicaid, benefit from public health spending. A surcharge could be placed on em- ployer-sponsored insurance (including Department of Defense health coverage and the Fed- eral Employee Health Benefits Plan), which could be waived if insurers agree to a “prevention investment package.” I Taxes That Can Help Influence Behavior: Certain taxes can be used to promote healthy behaviors while also providing revenue for public health programs. Options include: L Soda and candy or snack taxes, which could reduce consumption of unhealthy foods and also make Americans healthier if the revenue from these taxes was earmarked for prevention. Researchers at Yale University report that national junk food taxes could gen- erate over $1.8 billion per year. 12 L Tobacco taxes, which have been shown to reduce smoking, and in many states, could be used to help to fund health programs. New York City, which increased its cigarette tax from eight cents a pack to $1.50 a pack, saw tobacco tax revenues increase from just under $50 million per year to over $200 million per year through 2006.13 States can raise tobacco taxes on top of the recent 62 cent increase in the federal tax that is being used to support the State Children’s Health Insurance Program L Federal alcohol taxes are at historically low levels and they are inconsistently levied on beer, wine, and liquor. Equalizing federal excise taxes could raise nearly $8 billion, in- creasing public health funding while at the same time reducing alcohol-related injuries, suicides, and unhealthy alcohol use. L Food advertising profits tax. Annually, there is nearly $11 billion in spending on direct media advertising in the United States. Nearly 70 percent of that amount is spent on con- venience foods, candy snacks, alcoholic beverages, soft drinks, and desserts.14 Profits media outlets make from these sales could be taxed. 7 How Public Health is Funded 2 SECTION P ublic health programs are funded through a combination of federal, state, and local dollars. Each level of government has different, but There is a significant delay from the time important responsibilities for protecting the when a President proposes a fiscal year public’s health. While this report focuses pri- budget, to when appropriations legislation marily on federal funding to states, it also is signed into law, to the time when the provides information about state funding. funds are disbursed. Therefore, TFAH uses FY 2008 data for this analysis, which is the TFAH analyzes federal and state funding budget year for which the data are most for public health based on the most com- complete and accurate. plete financial data currently available. Federal Investment in Public Health On the state profile pages of the report, partments to distribute to hospitals for pre- TFAH highlights the amount of federal fund- paredness upgrades.16 ing states receive for a range of public health Approximately 75 percent of CDC’s budget is programs from CDC, the Health Resources distributed to states, localities, and other pub- and Services Administration (HRSA), and lic and private partners to support services the Office of the Assistant Secretary of Pre- and programs. Some of CDC’s funding is paredness and Response (ASPR). based on the number of people in a state or HRSA distributes approximately 90 percent on a need-based formula for priority pro- of its funding in grants to states and territo- grams. Other funds are based on competitive ries, public and private health care providers, grants. States can apply to CDC for funding health professions training programs and for specific program areas. Not all states that other organizations.15 ASPR received $633 apply for funds receive them because there million in funding in FY 2008, of which $398 are often insufficient funds appropriated to million went to state and local health de- allow all states to receive grants. WHAT ARE THE FEDERAL GOVERNMENT’S PUBLIC HEALTH OBLIGATIONS? In partnerships with states and localities, the federal government has an obligation to: I Assure the capacity for all levels of government to provide essential public health services; I Act when health threats may span many states, regions, or the whole country; I Act where the solution may be beyond the jurisdiction of individual states; I Act to assist the states when they do not have the expertise or resources to mount an effective re- sponse in a public health emergency such as a natural disaster, bioterrorism, or an emerging disease; I Facilitate the formulation of public health goals in collaboration with state and local governments and other relevant stakeholders; I Be transparent and accountable for public health investments; and I Disseminate innovation and best practices from state and local public health. Source: Trust for America’s Health. Public Health Leadership Initiative an Action Plan for Healthy People in Healthy Communities in the 21st Century. 17 9 Summary of CDC Dollars -- FY 2008 State CDC Total CDC Per Capita CDC Per Capita (All Categories) Total Ranking Alaska $36,220,618 $52.78 1 Vermont $21,835,627 $35.15 2 Wyoming $17,273,974 $32.43 3 Rhode Island $33,718,139 $32.09 4 New Mexico $61,403,641 $30.94 5 South Dakota $23,422,051 $29.12 6 North Dakota $17,607,787 $27.45 7 Hawaii $32,919,084 $25.55 8 Delaware $21,806,116 $24.98 9 Montana $23,541,460 $24.33 10 Maine $30,970,487 $23.53 11 Maryland $129,116,215 $22.92 12 West Virginia $39,515,180 $21.78 13 New York $416,872,239 $21.39 14 Washington $139,782,186 $21.34 15 Louisiana $93,735,053 $21.25 16 New Hampshire $27,719,305 $21.07 17 Idaho $31,958,157 $20.97 18 Massachusetts $135,514,801 $20.85 19 Nebraska $36,639,529 $20.54 20 Mississippi $58,888,474 $20.04 21 Nevada $51,143,160 $19.67 22 Arkansas $54,781,134 $19.19 23 Oklahoma $69,582,765 $19.10 24 North Carolina $175,248,392 $19.00 25 South Carolina $83,728,364 $18.69 26 Georgia $180,956,083 $18.68 27 Connecticut $65,236,094 $18.63 28 Colorado $88,522,335 $17.92 29 NATIONAL AVERAGE $17.60 Arizona $112,443,149 $17.30 30 Texas $417,444,172 $17.16 31 Alabama $79,016,361 $16.95 32 Illinois $214,962,853 $16.66 33 Iowa $49,160,565 $16.37 34 Oregon $61,903,758 $16.33 35 California $585,918,083 $15.94 36 Michigan $157,697,484 $15.76 37 New Jersey $136,758,751 $15.75 38 Utah $43,052,657 $15.73 39 Minnesota $81,747,496 $15.66 40 Kansas $42,419,311 $15.14 41 Missouri $89,491,706 $15.14 41 Wisconsin $84,276,182 $14.97 43 Tennessee $92,960,882 $14.96 44 Pennsylvania $174,123,991 $13.99 45 Kentucky $59,532,451 $13.94 46 Florida $243,563,273 $13.29 47 Virginia $100,068,077 $12.88 48 Ohio $146,519,336 $12.76 49 Indiana $81,208,839 $12.74 50 District of Columbia $98,964,121 NA* NA* U.S. TOTAL $5,352,891,948 $17.60 NA** Notes: *D.C. was not included in the per capita rankings because it receives different funding levels than the 50 states. **The U.S. total reflects CDC monies to all 50 states and D.C *** The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008 10 Summary of HRSA Dollars -- FY 2008 State HRSA Total HRSA Per Capita HRSA Per Capita Total Ranking (All Programs) (All Programs) Alaska $48,358,459 $70.75 1 Maryland $270,622,176 $48.17 2 Mississippi $111,881,930 $38.33 3 Montana $34,851,298 $36.38 4 Massachusetts $232,216,634 $36.00 5 West Virginia $62,039,237 $34.24 6 New Mexico $65,883,562 $33.44 7 Hawaii $41,186,239 $32.09 8 New York $548,149,085 $28.40 9 South Dakota $21,448,721 $26.94 10 Rhode Island $26,025,026 $24.60 11 Washington $156,787,361 $24.24 12 Louisiana $103,663,693 $24.15 13 Alabama $111,590,471 $24.11 14 South Carolina $105,340,508 $23.90 15 North Dakota $15,087,013 $23.58 16 Vermont $14,165,229 $22.80 17 Colorado $105,906,655 $21.78 18 NATIONAL AVERAGE $21.43 Maine $27,135,738 $20.60 19 Wyoming $10,742,939 $20.55 20 Delaware $17,498,587 $20.24 21 Florida $357,249,277 $19.57 22 Idaho $29,134,290 $19.43 23 Connecticut $66,167,554 $18.89 24 Oregon $68,710,632 $18.34 25 Arkansas $49,202,740 $17.36 26 Missouri $101,802,743 $17.32 27 Illinois $221,165,510 $17.21 28 New Jersey $148,152,925 $17.06 29 Tennessee $104,890,871 $17.04 30 Kentucky $71,120,810 $16.77 31 Iowa $49,097,111 $16.43 32 Georgia $153,462,033 $16.08 33 Pennsylvania $198,609,748 $15.97 34 California $563,425,406 $15.41 35 Nebraska $27,316,904 $15.39 36 North Carolina $138,140,389 $15.25 37 New Hampshire $19,801,741 $15.05 38 Texas $341,164,609 $14.27 39 Utah $37,100,062 $14.02 40 Nevada $35,860,118 $13.98 41 Viginia $103,240,575 $13.39 42 Oklahoma $47,103,686 $13.02 43 Arizona $81,532,014 $12.86 44 Michigan $122,293,351 $12.14 45 Wisconsin $63,205,970 $11.28 46 Ohio $127,240,045 $11.10 47 Minnesota $57,499,590 $11.06 48 Indiana $65,480,314 $10.32 49 Kansas $27,646,209 $9.96 50 District of Columbia $116,323,431 *NA NA* U.S. Total $5,723,721,219 $21.43 NA** Notes: *D.C. was not included in the per capita rankings because total funding for D.C. include funds for a number of national organizations. ** The U.S. total reflects HRSA grants to all 50 states and the District of Columbia. 11 Summary of ASPR HPP Dollars - FY 2008 State HPP Total HPP Per Capita HPP Per Capita Total Ranking Wyoming $1,124,115 $2.15 1 Vermont $1,256,092 $2.02 2 North Dakota $1,270,585 $1.99 3 Alaska $1,312,013 $1.92 4 South Dakota $1,447,580 $1.82 5 Delaware $1,534,297 $1.77 6 Montana $1,644,766 $1.72 7 Rhode Island $1,793,799 $1.70 8 Hawaii $2,057,849 $1.60 9 Maine $2,101,569 $1.60 9 New Hampshire $2,093,475 $1.59 11 Idaho $2,277,157 $1.52 12 West Virginia $2,703,739 $1.49 13 Nebraska $2,642,978 $1.49 13 New Mexico $2,868,709 $1.46 15 NATIONAL AVERAGE $1.43 Kansas $3,849,684 $1.39 16 Mississippi $4,027,180 $1.38 17 Arkansas $3,906,396 $1.38 17 Iowa $4,113,883 $1.38 19 Nevada $3,524,243 $1.37 20 Utah $3,590,331 $1.36 21 Connecticut $4,747,354 $1.36 21 Oklahoma $4,837,520 $1.34 23 Oregon $4,984,817 $1.33 24 Louisiana $5,696,194 $1.33 24 Kentucky $5,597,192 $1.32 26 Alabama $6,073,401 $1.31 27 South Carolina $5,736,768 $1.30 28 Minnesota $6,761,826 $1.30 28 Maryland $7,305,500 $1.30 30 Wisconsin $7,233,733 $1.29 31 Missouri $7,580,577 $1.29 31 Colorado $6,260,449 $1.29 31 Massachusetts $8,301,006 $1.29 31 Indiana $8,151,131 $1.28 35 Washington $8,250,841 $1.28 35 New Jersey $11,072,985 $1.27 37 Tennessee $7,818,211 $1.27 37 Virginia $9,762,140 $1.27 37 Michigan $12,734,552 $1.26 40 Arizona $7,972,742 $1.26 40 Ohio $14,409,789 $1.26 40 Pennsylvania $15,576,347 $1.25 43 Georgia $11,847,828 $1.24 44 North Carolina $11,232,884 $1.24 44 Florida $22,422,494 $1.23 46 Texas $28,988,249 $1.21 47 Illinois $12,605,863 $0.98 48 California $32,625,884 $0.89 49 New York $13,941,707 $0.72 50 District of Columbia $1,707,585 *NA NA* U.S. TOTAL $361,670,222 $1.43 NA** Notes: *D.C. was not included in the per capita rankings ** Total includes $36 million in HPP monies for four major U.S. metropolitan areas, Washington, D.C., Chicago, L.A. County, and New York City, U.S. Territories such as Puerto Rico and Guam, and the Freely Associated States of the Pacific, such as the Marshall Islands. 12 State Investment in Public Health In FY 2008, per capita public health funding Hawaii. The median funding for public by state governments ranged from $3.37 per health was $33.71 per person. person in Nevada to $172.21 per person in WHAT ARE STATE AND LOCAL GOVERNMENTS’ PUBLIC HEALTH OBLIGATIONS? The public health systems are set up different in each state. Some states have centralized sys- tems, some have more localized systems, and some have a hybrid system. Based on the system in a state, the responsibilities for public health may rest more at the state level, local level, or a combination of the two levels of government. Overall, states and localities have an obligation to: I Fulfill core public health functions such as diagnosing and investigating health threats, inform- ing and educating the public, mobilizing community partnerships, protecting against natural and human-made disasters, and enforcing state health laws; I Provide relevant information on the community’s health and the availability of essential pub- lic health services. This information should be integrated with reporting from local hospitals and health care providers to show how well public concerns and health threats are being ad- dressed. These reports should also be publicly available and utilized by public health depart- ments to work collaboratively with hospitals, physicians, and others with a role in public health to set health goals; I Work collaboratively with the multiple stakeholders who influence public health at the com- munity level in designing appropriate programs and interventions that address key health problems and improve the health of the region; and I Deal with complex, poorly understood problems by acting as “policy laboratories.” States and localities are closer to the people and to the problems causing ill health. Trust for America’s Health. Public Health Leadership Initiative an Action Plan for Healthy People in Healthy Communities in the 21st Century.19 13 State Public Health Budgets State FY 2007-2008 FY 07-08 Per Capita Per Capita Ranking Hawaii 2 $221,008,697 $172.21 1 Vermont 3 $90,222,763 $145.23 2 District of Columbia $67,703,000 $115.08 3 California 8 $3,070,883,069 $84.01 4 Idaho $117,390,200 $78.29 5 West Virginia $139,404,494 $76.93 6 New York $1,328,537,400 $68.84 7 Oklahoma 1,8 $240,042,246 $66.36 8 Massachusetts 4 $425,187,621 $65.92 9 Wyoming $33,561,119 $64.19 10 New Mexico $123,277,100 $62.58 11 Alabama $270,565,257 $58.46 12 Delaware 2 $45,431,100 $52.54 13 Tennessee $313,513,800 $50.92 14 Rhode Island $53,487,559 $50.56 15 Colorado $241,227,816 $49.62 16 Louisiana $206,987,822 $48.21 17 Alaska 2 $31,433,600 $45.99 18 Kentucky $179,848,193 $42.40 19 Virginia 4 $320,724,724 $41.59 20 Washington 4 $268,638,500 $41.53 21 South Carolina $180,538,528 $40.96 22 Maryland 2 $214,244,000 $38.13 23 Nebraska 4 $65,069,351 $36.67 24 New Jersey $303,664,000 $34.96 25 MEDIAN $33.71 Utah 8 $89,182,200 $33.71 26 Florida 2 $545,458,887 $29.89 27 South Dakota $22,683,983 $28.49 28 Arkansas $77,373,002 $27.29 29 Maine 2 $35,326,645 $26.82 30 Montana $24,280,665 $25.35 31 Illinois $301,629,600 $23.47 32 Connecticut 2 82,104,494 $23.44 33 New Hampshire $30,300,891 $23.03 34 Michigan 4 $213,486,300 $21.20 35 Pennsylvania 2 $249,951,000 $20.10 36 Iowa $58,274,612 $19.50 37 Kansas $52,373,831 $18.87 38 Georgia 6,8 $174,971,859 $18.33 39 Arizona $113,795,500 $17.95 40 North Dakota 7 $10,824,747 $16.92 41 North Carolina 2 $147,749,787 $16.31 42 Minnesota 2 $84,582,000 $16.27 43 Texas 8 $381,626,020 $15.96 44 Indiana $97,735,693 $15.40 45 Ohio 4 $172,616,353 $15.05 46 Oregon $54,315,766 $14.49 47 Mississippi 2,8 $36,903,314 $12.64 48 Wisconsin 4 $58,849,240 $10.51 49 Missouri 5,8 $51,802,017 $8.81 50 Nevada $8,686,841 $3.37 51 Notes: 1 May contain some social service programs, but not Medicaid or CHIP . 2 General funds only. 3 Includes federal funds. 4 Budget data taken from appropriations legislation. 5 Missouri’s percent change based on FY 2006-07 and FY 2007-08 actual expenditures. 6 Georgia’s budget data for FY 2006-07 taken from appropriations legislation. 7 North Dakota’s budget data for the 2007-2009 biennium taken from appropriations legislation. 8 Excludes one-time funding for Anti-Virals. 14 The Impact of the Recession on State and Local Public Health Budgets On December 1, 2008 the National Bureau The state budget crisis is also likely to have a of Economic Research released a statement negative impact on the public health work- confirming that the United States officially force. A preliminary survey of local health entered a recession in December 2007.20 departments by the National Association of Due to the recession, states are encountering County and City Health Officials (NAC- great economic distress and many have tried CHO) has found both budget cuts and work- to close shortfalls by increasing taxes and/or force reductions to health departments. A cutting spending. Currently, at least 46 states survey of 2,422 local health departments na- face shortfalls to their 2009 and/or 2010 tionally in November-December 2008 found budgets. At the current rate of economic de- that more than half of local health depart- terioration, and the course of past recessions, ments have either laid off employees or lost the Center on Budget and Policy Priorities them through attrition. Because of the cur- predicts that combined budget gaps for the rent budget limitations, health departments remainder of 2009, and state fiscal years 2010 have been unable to replace the lost workers, and 2011 to total more than $350 billion.21 and they anticipate more cuts in 2009.30 Almost every state is required by law to bal- The economic difficulties states are facing ance its budget, and as revenue continues to are on top of an already distressed public fall, states are forced to cut spending or in- health workforce. According to a 2007 sur- crease taxes.22 From July to September 2008 vey by ASTHO, over 100,000 workers are em- tax revenue was flat in 42 states for which ployed in state public health, in addition to data is available, compared with the same pe- the 160,000 workers NACCHO estimates are riod in 2007.23 Once inflation is taken into employed in local health departments.31 account, the total revenue collections are However, by 2020, the Association of Schools below 2007 levels in 36 of the 42 states.24 of Public Health estimates that state and Sales tax revenue and personal income tax local health departments will need an addi- revenue are also both down as a result of the tional 250,000 public health workers.32 weak economy.25 Public health workers are the backbone of the In order to balance their budgets, states have U.S. public health system and carry out a range started enacting cuts to state services.26 Al- of duties including epidemiologic surveillance, ready, at least 28 states have implemented laboratory testing and analysis, prevention and cuts that will make it more difficult for low-in- treatment of infectious and chronic diseases, come children and families to access health and emergency preparedness. care.27 For example, in Nevada the governor The public health workforce, however, is seri- capped the State Children’s Health Insur- ously strained according to the 2007 ASTHO ance Program (SCHIP) close to its current survey. Twenty-four states have 25 percent or number of enrollees, and also increased the more of their state public health workforce el- premiums current members must pay.28 igible to retire within in the next five years, Many programs for the elderly and disabled while 10 states have 35 percent or more of have also been cut, and states are signifi- their state public health workforce eligible to cantly increasing the amount the elderly and retire. Only seven states have less than 25 per- disabled have to pay for services such as med- cent of their state public health workforce el- ical, rehabilitative, and home care.29 igible to retire within the next five years. 15 Public Health Workforce Eligible to Retire within the Next Five Years States with < 25% of workforce States with ≥ 25% of workforce eligible eligible for retirement. for retirement. Connecticut (19%) Alabama (32%) Minnesota (27%) North Carolina (23%) Alaska (27%) Missouri (37%) Ohio (14%) Colorado (37%) Montana (34%) South Carolina (15%) Delaware (25%) Nebraska (56%) Tennessee (16%) Georgia (25%) New Hampshire (50%) Texas (23%) Illinois (39%) New Jersey (49%) Utah (22%) Indiana (25%) North Dakota (27%) Iowa (30%) Oklahoma (29%) Maryland (31%) Oregon (32%) Michigan (39%) Pennsylvania (29%) Virginia (60%) West Virginia (30%) Wisconsin (54%) Wyoming (32%) Source: ASTHO’s 2007 State Public Health Workforce Survey Results Note: Twenty states did not respond to ASTHO’s survey (AR, AZ, CA, DC, FL, HI, ID, KS, KY, LA, MA, ME, MI, NV, NM, NY, RI, SD, VT, and WA). Another survey by ASTHO from November- turned away because of state services cuts.35 December 2008 assessing how the current Most tax increases and spending cuts at the economic environment is affecting state and state level can have long term negative con- territorial health agencies found more sequences for helping states rebound eco- budget reductions severely affecting the nomically in addition to hurting state workforce. According to the survey: services. (Tobacco taxes are a notable ex- I Two states have already lost 15 percent of ception.)36 For instance, in order to cut their workforce through attrition. spending, states lay off employees, cancel contracts with vendors, and decrease or elim- I One of these states expects to lose another inate benefit payments to individuals, which 15 percent in the next fiscal year. in turn decreases demand because individu- I The vacancy rates at state health depart- als who would have received salaries or ben- ments range from 2 percent to 17 percent, efits prior to the cuts now have less money with 44 percent of states having a vacancy for consumption. When states increase taxes rate of 10 percent or higher they also reduce the amount of money peo- ple have to spend, which is likely to injure the I At least 29 percent of states expect to lose economy even more. Because the federal staff through layoffs or attrition in FY09.33 government can run deficits it is in a position Experts are concerned that state budget cuts to provide assistance to states and localities will have a harmful effect on public health.34 in order to prevent an even deeper down- One of the biggest concerns is that many in- turn.37 Investing money earlier, rather than dividuals will be in even more desperate need waiting until the recession is almost over will of state services due to the recession, yet they lessen the burden states feel to make spend- are more likely to be denied coverage or be ing cuts and increase taxes.38 16 Public Health, Accountability and Transparency 3 SECTION A strong public health system focused on the prevention of disease and injury is essential to protecting the health and safety of all Americans. But today, our public health systems is not held as accountable in an adequate way for to track how public health dollars are spent, or what health outcomes are achieved. Also, while federal investments can be compared across states, it is much more difficult to compare one state’s spending to another’s. In the current economic climate, calls for ac- Act of 2009 called for strong accountability countability are heightened, as policymakers measures to be tied to funding of prevention and the public want to ensure taxpayer dollars and wellness funding, including directing the are being used as effectively as possible, and U.S. Department of Health and Human Serv- that public health funds are having a direct ices to come up with an accountability plan impact on improving the health of Americans. within 90 days for spending the resources in The American Recovery and Reinvestment the most effective way possible. “THE ADMINISTRATION IS COMMITTED TO INVESTING RECOVERY ACT DOLLARS WITH AN UNPRECEDENTED LEVEL OF TRANSPARENCY AND ACCOUNTABILITY SO AMERICANS KNOW WHERE THEIR TAX DOLLARS ARE GOING AND HOW THEY ARE BEING SPENT.” -- PETER ORSZAG, DIRECTOR OF THE OFFICE OF MANAGEMENT AND BUDGET39 Accountability objectives outlined by Office of Management and Budget for the American Recovery and Reinvestment Act of 2009: I Funds are awarded and distributed in a prompt, fair, and reasonable manner; I The recipients and uses of all funds are transparent to the public, and the public benefit of these funds are reported clearly, accurately, and in a timely manner; I Funds are used for authorized purposes and instances of fraud, waste, error, and abuse are mitigated; I Projects funded under this Act avoid unnecessary delays and cost overruns; and I Program goals are achieved, including specific program outcomes and improved results on broader economic indicators. 17 CDC lists “accountability” as one of three core ices or that government funding is being spent values: “As diligent stewards of public trust and in the most effective way, reporting standards public funds, we act decisively and compas- and accountability efforts must be established. sionately in service to the people’s health. We In 2008, TFAH convened a number of ex- ensure that our research and our services are perts from government, academia, the pri- based on sound science and meet real public vate sector, and public health organizations needs to achieve our public health goals.”40 and asked them to make recommendations However, in practice, the link between the al- for improving accountability throughout the location of public health dollars and the pub- public health system. Their top recommen- lic health outcomes from these dollars is dations included: limited at best. As a result, accountability for I Linking accountability to measurable im- public health programs is virtually impossi- provements in the health of communities; ble and will remain so until there is greater transparency and integration of budget and I Creating policies, incentives, and other performance at the federal, state, and local mechanisms that will encourage account- levels. Many of the public health outcomes ability and continuous quality improve- are a result of investments over time, and ment; and year-by-year comparison makes it difficult to I Expanding accreditation for public health show how the public health program dollars systems to support accountability.41 directly lead to outcomes. For accountability efforts to be successful, State and local health departments are struc- the federal government must provide strong tured in a range of ways causing budgets to leadership, state and local government must be allocated and reported in different styles be given adequate resources to be able to and varying levels of detail. The variability make changes, and officials must build on in state structures and differences in the level existing accountability and accreditation pro- of detail they provide about public health grams. The federal, state, and local govern- funding make it a challenge to compare ments must also help incentivize and spending on a state-by-state basis. encourage the private sector to be increas- Americans deserve basic health protections, ingly involved in public health and help pro- and to ensure minimum levels of health serv- vide support within communities. 18 Recommendations A merica faces a major health crisis. Quality, affordable health care is essential, but a strong public health system focused on prevention must also be part of the solution. The health crisis calls for urgent action by 4 SECTION putting prevention at the center of the nation’s health strategy. Preventing and combating threats to our this spending. Another is enhancing efforts health is the primary responsibility of our na- to track disease rates and trends in communi- tion’s public health system. Keeping America ties, states, and the nation. healthier will require a greater upfront in- It is essential that funding for public health vestment as well as sustained funding streams be considered as an integral part of compre- in prevention programs which pays off in bet- hensive health care reform. Universal, qual- ter health and keeping treatment costs down. ity care is needed to give all Americans the One central aspect to gaining a better under- opportunity to be as healthy as they can be, standing of how public health programs can but that is not enough. The government reduce disease rates will be an increased com- must also create strategies to improve the mitment to tracking where and how public health of all Americans. health funding is spent and the outcomes of Recommendations for Sustained Funding Federal, state, and local governments should The country should commit to a long term increase public health funding to adequately goal of increased and sustained funding for support core functions public health. An analysis by NYAM and TFAH found that adequately funding public health would require a total of $55 to $60 bil- lion annually (approximately $187 per person) on public health, and that the breakdown of the funding should be 60 percent from the federal government (an additional $12 billion annually) and 40 percent from state and local governments ($8 billions annually). Federal, state, and local elected leaders Long-term strategies for restoring and increas- should examine long-term strategies for ing federal support for public health could funding public health. come from new revenue streams and/or from reviewing existing revenue streams such as Medicare, Medicaid, private payers as well as public health dollars. Possible options for new revenue streams include surcharges on health care funding mechanisms and taxes that can help influence behavior such as soda, candy, snack or tobacco taxes. 19 Recommendations for Accountability The federal government should create a pilot The CDC should establish a pilot program program to give state and local health depart- where state and local health departments ments greater flexibility with the use of pre- would be allowed greater flexibility for how vention and preparedness funds in exchange they use federal funds in exchange for for more accountability for improving health greater accountability for improving health in communities. outcomes and measures in communities. The program would reward, incentivize, and equip states and localities that are commit- ted to accountability for improving health outcomes and could be applied more broadly to improve prevention initiatives for the entire public health system. The federal government should create a Many state and local agencies are not in a funding stream to help state and local health position to prepare for accreditation, pay for departments pay for accountability capacity self-assessments or undertake other contin- development. uous quality improvement efforts. In order to help state and local agencies improve their accountability they should receive fed- eral financial support through either a dedi- cated funding stream or a set-aside from existing grants. They can also improve their accountability through the use of grant money to prepare for national accreditation. The federal government should create a This research institute should invest in best public health research institute. practices, generate data pertaining to health outcomes and workforce issues, address com- plex problems like social determinants of health, focus on prevention, and assist in the development of accountability measures. Pub- lic health spending should be transparent and tracked to ensure that it is being invested effec- tively toward improving health in communities. The federal government should encourage Even though much of the federal funding for governors, mayors, and other locally elected health passes through health departments, it officials to become more directly accountable. is important that elected officials commit to any accountability process, such as engaging in all relevant government agencies and sign- ing Memorandums of Understanding outlin- ing clear goals when receiving federal funds. Another approach could be to tie Medicaid and other federal health funding to state and local investment in prevention and to the participation of state and local agencies in ac- countability processes, such as accreditation. Federal, state, and local governments should Health departments should have to demon- establish guidelines and measures for core strate that they have met minimum accounta- public health functions and require that bility standards in order to receive federal states and localities report the findings to the funding for such functions. The minimum public and federal government. guidelines should move beyond process to focus on quantitative objectives and outcomes to help ensure an institutions capacity to meet core functions and high-priority services. The federal government would have to compile, analyze, and report on these measures to pol- icymakers and the public on a regular basis. 20 Recommendations for Public Health as Part of Health Care Reform The federal government should provide As part of health care reform, the federal universal, quality health care. government and Congress should provide universal, quality coverage and access to give all Americans the opportunity to be as healthy as they can be. The federal government should make As part of health care reform, the federal disease prevention a priority of the reformed government and Congress should invest in health system. community- and clinical-based disease pre- vention to ensure that universal coverage is as cost-effective as possible by keeping Americans healthier. The federal government should make public As part of health care reform, the federal health an integral part of health care reform. government and Congress should ensure that any health care financing system that is developed includes stable and reliable fund- ing for core public health functions at all lev- els of government, including supporting community- and clinical-based preventive services as well as a bolstered workforce and modernized information systems for both health care and public health needs. 21 THE STATE OF YOUR HEALTH: ALABAMA State Rank* U.S. Census Bureau 2008 Data Total Population 4,661,900 N/A % Uninsured, All Ages 12.0% 32 % Uninsured, 18 and under 7.3% 36 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 29.6% (+/- 1.1) 6 AIDS: Cumulative Cases Aged 13 & Over (2006) 8,626 24 Alzheimer’s Disease: Estimated Cases (2010) 91,000 21 Asthma: 2005-2007 3 Yr Average (95% CI) 12.6% (+/- 0.9) 31 Cancer: Estimated New Cases (2008) 22,340 24 Chlamydia: Rates per 100,000 Population (2007) 546.9 5 Diabetes: 2005-2007 3 Yr Average (95% CI) 10.0% (+/- 0.6) 4 Human West Nile Virus: New Cases (2008) 21 14 Hypertension: 2003-2007 3 Yr Average (95% CI) 33.5% (+/- 1.0) 2 Obesity: 2005-2007 3 Yr Average (95 % CI) 30.1% (+/- 1.2) 3 Syphilis: Rates per 100,000 Population (2007) 8.3 3 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 23.5% (+/- 1.2) 9 Tuberculosis: Number of Cases (2007) 175 21 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 76 19 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 21.8% 34 Infant Mortality: Per 1,000 Live Births (2005) 9.4 4 Low Birthweight: % of Total Births (2006) 10.5% 4 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 16.7% 11 Pre-Term Labor: % of Live Births (2006) 17.1% 2 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not-Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 86 33 Health Professions Shortage Areas - Mental Health (FY 2008) 48 21 Health Professions Shortage Areas - Dental Care (FY 2008) 62 29 Nursing Shortage Estimates (2010) -200 46 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 37,000 22 Potential # of Episodes of Illness During a Severe Pandemic 1,350,000 23 Potential Financial Loss During a Severe Pandemic, % of GDP 5.45% 33 Potential Financial Loss During a Severe Pandemic, $ amount $8.3 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 23 THE STATE OF YOUR HEALTH: ALABAMA Public Health Funding Facts Federal Funding for Alabama’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $16.95 32 Health Resources and Services Administration (HRSA) FY 2008 $24.11 14 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.31 27 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $515,954 Cancer $5,035,823 Chronic Disease Prevention and Health Promotion $4,427,710 Diabetes $380,359 Environmental Health $299,040 Heart Disease $382,768 HIV/AIDS $3,527,760 Immunization (Sect. 317 and Vaccines for Children Program) $41,879,755 Infectious Diseases $1,087,129 Injury and Violence Prevention $1,606,504 Nutrition and Physical Activity $82,250 Occupational Safety and Health $861,238 Pandemic Flu $858,564 Preventive Health and Health Services Block Grant $1,609,081 School Health $223,612 Sexually Transmitted Diseases (STD) $4,223,298 Tobacco $0 Terrorism Preparedness and Emergency Response $10,766,811 Tuberculosis $1,078,062 Total FY 2008 CDC Dollars (All Categories) $79,016,361 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $13,159,513 HIV/AIDS $26,497,698 Maternal & Child Health $17,527,673 Primary Health Care $39,896,764 Total FY 2008 HRSA Dollars (All Categories) $111,590,471 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $6,073,401 Total FY 2008 ASPR HPP Dollars $6,073,401 State Spending State Per Capita Funding for Alabama’s Health: $58.46 State Per Capita Funding Ranking:12 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 24 THE STATE OF YOUR HEALTH: ALASKA State Rank* U.S. Census Bureau 2008 Data Total Population 686,293 N/A % Uninsured, All Ages 18.2% 7 % Uninsured, 18 and under 11.4% 15 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 20.9% (+/- 1.4) 39 AIDS: Cumulative Cases Aged 13 & Over (2006) 648 45 Alzheimer’s Disease: Estimated Cases (2010) 5,000 51 Asthma: 2005-2007 3 Yr Average (95% CI) 13.5% (+/- 1.2) 16 Cancer: Estimated New Cases (2008) 2,650 49 Chlamydia: Rates per 100,000 Population (2007) 732.9 3 Diabetes: 2005-2007 3 Yr Average (95% CI) 5.5% (+/- 0.7) 50 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 23.9% (+/- 1.4) 48 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.3% (+/- 1.5) 14 Syphilis: Rates per 100,000 Population (2007) 1.0 37 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 23.7% (+/- 1.5) 7 Tuberculosis: Number of Cases (2007) 51 36 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 7 44 Asthma: High School Students (2007) 18.2% (+/- 2.0) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 29.9% 6 Infant Mortality: Per 1,000 Live Births (2005) 5.9 38 Low Birthweight: % of Total Births (2006) 6.0% 51 Obesity Rates, % High School Students (2007) 11.1% (+/-2.2) N/A Obesity Rates, % Children Age 10-17 (2004) 11.1% 44 Pre-Term Labor: % of Live Births (2006) 11.2% 43 Tobacco: Current Smokers High School Students (2007) 24.1% (+/- 2.5) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not-Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 71 37 Health Professions Shortage Areas - Mental Health (FY 2008) 52 18 Health Professions Shortage Areas - Dental Care (FY 2008) 45 36 Nursing Shortage Estimates (2010) -2,300 35 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 4,000 51 Potential # of Episodes of Illness During a Severe Pandemic 192,000 47 Potential Financial Loss During a Severe Pandemic, % of GDP 6.59% 3 Potential Financial Loss During a Severe Pandemic, $ amount $2.6 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 25 THE STATE OF YOUR HEALTH: ALASKA Public Health Funding Facts Federal Funding for Alaska’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $52.78 1 Health Resources and Services Administration (HRSA) FY 2008 $70.75 1 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.92 4 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $236,955 Birth Defects and Developmental Disabilities $537,064 Cancer $7,809,526 Chronic Disease Prevention and Health Promotion $2,511,166 Diabetes $787,633 Environmental Health $115,735 Heart Disease $1,380,199 HIV/AIDS $1,905,969 Immunization (Sect. 317 and Vaccines for Children Program) $12,876,780 Infectious Diseases $706,280 Injury and Violence Prevention $716,303 Nutrition and Physical Activity $0 Occupational Safety and Health $75,000 Pandemic Flu $161,539 Preventive Health and Health Services Block Grant $332,961 School Health $232,651 Sexually Transmitted Diseases (STD) $427,698 Tobacco $0 Terrorism Preparedness and Emergency Response $5,000,000 Tuberculosis $407,159 Total FY 2008 CDC Dollars (All Categories) $36,220,618 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $3,049,732 HIV/AIDS $1,999,782 Maternal & Child Health $2,516,682 Primary Health Care $32,774,777 Total FY 2008 HRSA Dollars (All Categories) $48,358,459 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,312,013 Total FY 2008 ASPR HPP Dollars $1,312,013 State Spending State Per Capita Funding for Alaska’s Health: $45.99 State Per Capita Funding Ranking:18 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 26 THE STATE OF YOUR HEALTH: ARIZONA State Rank* U.S. Census Bureau 2008 Data Total Population 6,500,180 N/A % Uninsured, All Ages 18.3% 6 % Uninsured, 18 and under 13.8% 6 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 22.4% (+/- 1.4) 30 AIDS: Cumulative Cases Aged 13 & Over (2006) 10,396 22 Alzheimer’s Disease: Estimated Cases (2010) 97,000 19 Asthma: 2005-2007 3 Yr Average (95% CI) 13.6% (+/- 1.1) 13 Cancer: Estimated New Cases (2008) 25,540 20 Chlamydia: Rates per 100,000 Population (2007) 403.3 16 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.1% (+/- 0.8) 19 Human West Nile Virus: New Cases (2008) 109 2 Hypertension: 2003-2007 3 Yr Average (95% CI) 24.2% (+/- 1.2) 46 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.3% (+/- 1.5) 38 Syphilis: Rates per 100,000 Population (2007) 4.8 11 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.4% (+/- 1.4) 32 Tuberculosis: Number of Cases (2007) 304 10 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 46 24 Asthma: High School Students (2007) 23.0% (+/- 2.1) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 24.8% 15 Infant Mortality: Per 1,000 Live Births (2005) 6.9 25 Low Birthweight: % of Total Births (2006) 7.1% 36 Obesity Rates, % High School Students (2007) 11.7% (+/- 2.5) N/A Obesity Rates, % Children Age 10-17 (2004) 12.2% 38 Pre-Term Labor: % of Live Births (2006) 13.2% 21 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not-Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 139 13 Health Professions Shortage Areas - Mental Health (FY 2008) 48 21 Health Professions Shortage Areas - Dental Care (FY 2008) 78 20 Nursing Shortage Estimates (2010) -12,500 11 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 38,000 21 Potential # of Episodes of Illness During a Severe Pandemic 1,766,000 17 Potential Financial Loss During a Severe Pandemic, % of GDP 5.52% 27 Potential Financial Loss During a Severe Pandemic, $ amount $12.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 27 THE STATE OF YOUR HEALTH: ARIZONA Public Health Funding Facts Federal Funding for Arizona’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $17.30 30 Health Resources and Services Administration (HRSA) FY 2008 $12.86 44 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.26 40 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $343,189 Birth Defects and Developmental Disabilities $1,115,833 Cancer $4,505,230 Chronic Disease Prevention and Health Promotion $1,140,390 Diabetes $256,270 Environmental Health $119,820 Heart Disease $325,000 HIV/AIDS $6,078,747 Immunization (Sect. 317 and Vaccines for Children Program) $77,254,777 Infectious Diseases $1,095,819 Injury and Violence Prevention $1,029,715 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $146,711 Preventive Health and Health Services Block Grant $1,163,758 School Health $745,000 Sexually Transmitted Diseases (STD) $1,364,486 Tobacco $347,402 Terrorism Preparedness and Emergency Response $14,190,689 Tuberculosis $1,172,939 Total FY 2008 CDC Dollars (All Categories) $112,443,149 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,627,397 HIV/AIDS $24,056,348 Maternal & Child Health $10,097,477 Primary Health Care $37,764,125 Total FY 2008 HRSA Dollars (All Categories) $81,532,014 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $7,972,742 Total FY 2008 ASPR HPP Dollars $7,972,742 State Spending State Per Capita Funding for Arizona’s Health: $17.95 State Per Capita Funding Ranking:40 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 28 THE STATE OF YOUR HEALTH: ARKANSAS State Rank* U.S. Census Bureau 2008 Data Total Population 2,855,390 N/A % Uninsured, All Ages 16.1% 16 % Uninsured, 18 and under 6.2% 41 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 29.1% (+/- 0.9) 7 AIDS: Cumulative Cases Aged 13 & Over (2006) 3,891 33 Alzheimer’s Disease: Estimated Cases (2010) 60,000 31 Asthma: 2005-2007 3 Yr Average (95% CI) 11.7% (+/- 0.7) 41 Cancer: Estimated New Cases (2008) 14,840 31 Chlamydia: Rates per 100,000 Population (2007) 354.1 23 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.5% (+/- 0.5) 14 Human West Nile Virus: New Cases (2008) 9 26 Hypertension: 2003-2007 3 Yr Average (95% CI) 31.5% (+/- 0.9) 5 Obesity: 2005-2007 3 Yr Average (95 % CI) 28.1% (+/- 0.9) 9 Syphilis: Rates per 100,000 Population (2007) 4.3 14 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 23.2% (+/- 0.9) 10 Tuberculosis: Number of Cases (2007) 106 30 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 36 25 Asthma: High School Students (2007) 21.1% (+/- 3.3) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 27.7% 9 Infant Mortality: Per 1,000 Live Births (2005) 7.9 14 Low Birthweight: % of Total Births (2006) 9.2% 11 Obesity Rates, % High School Students (2007) 13.9% (+/- 2.5) N/A Obesity Rates, % Children Age 10-17 (2004) 16.4% 12 Pre-Term Labor: % of Live Births (2006) 13.7% 14 Tobacco: Current Smokers High School Students (2007) 28.3% (+/- 3.6) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not-Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 88 31 Health Professions Shortage Areas - Mental Health (FY 2008) 38 34 Health Professions Shortage Areas - Dental Care (FY 2008) 37 40 Nursing Shortage Estimates (2010) -2,700 32 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 22,000 30 Potential # of Episodes of Illness During a Severe Pandemic 823,000 32 Potential Financial Loss During a Severe Pandemic, % of GDP 5.81% 13 Potential Financial Loss During a Severe Pandemic, $ amount $5.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 29 THE STATE OF YOUR HEALTH: ARKANSAS Public Health Funding Facts Federal Funding for Arkansas’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $19.19 23 Health Resources and Services Administration (HRSA) FY 2008 $17.36 26 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.38 17 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $201,277 Birth Defects and Developmental Disabilities $1,172,622 Cancer $3,771,644 Chronic Disease Prevention and Health Promotion $557,524 Diabetes $407,679 Environmental Health $0 Heart Disease $1,233,033 HIV/AIDS $2,233,043 Immunization (Sect. 317 and Vaccines for Children Program) $30,720,952 Infectious Diseases $717,915 Injury and Violence Prevention $597,905 Nutrition and Physical Activity $686,621 Occupational Safety and Health $0 Pandemic Flu $326,400 Preventive Health and Health Services Block Grant $1,134,831 School Health $702,498 Sexually Transmitted Diseases (STD) $864,301 Tobacco $910,357 Terrorism Preparedness and Emergency Response $7,369,593 Tuberculosis $1,172,939 Total FY 2008 CDC Dollars (All Categories) $54,781,134 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,755,751 HIV/AIDS $9,654,675 Maternal & Child Health $8,921,688 Primary Health Care $22,709,090 Total FY 2008 HRSA Dollars (All Categories) $49,202,740 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $3,906,396 Total FY 2008 ASPR HPP Dollars $3,906,396 State Spending State Per Capita Funding for Arkansas’s Health: $27.29 State Per Capita Funding Ranking:29 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 30 THE STATE OF YOUR HEALTH: CALIFORNIA State Rank* U.S. Census Bureau 2008 Data Total Population 36,756,666 N/A % Uninsured, All Ages 18.2% 7 % Uninsured, 18 and under 10.7% 17 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 23.3% (+-/ 0.9) 23 AIDS: Cumulative Cases Aged 13 & Over (2006) 142,254 2 Alzheimer’s Disease: Estimated Cases (2010) 480,000 1 Asthma: 2005-2007 3 Yr Average (95% CI) 12.9% (+/- 0.7) 23 Cancer: Estimated New Cases (2008) 156,530 1 Chlamydia: Rates per 100,000 Population (2007) 389.3 18 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.6% (+/- 0.5) 28 Human West Nile Virus: New Cases (2008) 411 1 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.2% (+/- 0.9) 24 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.1% (+/- 0.9) 41 Syphilis: Rates per 100,000 Population (2007) 5.6 7 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 14.8% (+/- 0.8) 50 Tuberculosis: Number of Cases (2007) 2726 1 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 664 4 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.9% 24 Infant Mortality: Per 1,000 Live Births (2005) 5.3 44 Low Birthweight: % of Total Births (2006) 6.8% 45 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 13.2% 32 Pre-Term Labor: % of Live Births (2006) 10.7% 46 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not-Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 522 1 Health Professions Shortage Areas - Mental Health (FY 2008) 261 2 Health Professions Shortage Areas - Dental Care (FY 2008) 286 1 Nursing Shortage Estimates (2010) -47,600 1 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 253,000 1 Potential # of Episodes of Illness During a Severe Pandemic 10,713,000 1 Potential Financial Loss During a Severe Pandemic, % of GDP 5.36% 41 Potential Financial Loss During a Severe Pandemic, $ amount $86.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 31 THE STATE OF YOUR HEALTH: CALIFORNIA Public Health Funding Facts Federal Funding for California’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.94 36 Health Resources and Services Administration (HRSA) FY 2008 $15.41 35 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $0.89 49 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $758,388 Birth Defects and Developmental Disabilities $3,945,927 Cancer $12,194,408 Chronic Disease Prevention and Health Promotion $11,247,574 Diabetes $3,130,243 Environmental Health $4,912,994 Heart Disease $464,714 HIV/AIDS $61,636,140 Immunization (Sect. 317 and Vaccines for Children Program) $348,481,638 Infectious Diseases $8,380,559 Injury and Violence Prevention $10,667,174 Nutrition and Physical Activity $1,089,031 Occupational Safety and Health $3,875,622 Pandemic Flu $1,450,123 Preventive Health and Health Services Block Grant $6,730,544 School Health $2,783,511 Sexually Transmitted Diseases (STD) $13,015,433 Tobacco $404,970 Terrorism Preparedness and Emergency Response $73,943,044 Tuberculosis $16,349,046 Total FY 2008 CDC Dollars (All Categories) $585,918,083 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $23,663,244 HIV/AIDS $253,545,552 Maternal & Child Health $59,305,732 Primary Health Care $200,733,710 Total FY 2008 HRSA Dollars (All Categories) $563,425,406 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $32,625,884 Total FY 2008 ASPR HPP Dollars $32,625,884 State Spending State Per Capita Funding for California’s Health: $84.01 State Per Capita Funding Ranking:4 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 32 THE STATE OF YOUR HEALTH: COLORADO State Rank* U.S. Census Bureau 2008 Data Total Population 4,939,456 N/A % Uninsured, All Ages 16.4% 13 % Uninsured, 18 and under 13.0% 7 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 17.3% (+/- 0.6) 50 AIDS: Cumulative Cases Aged 13 & Over (2006) 8,742 23 Alzheimer’s Disease: Estimated Cases (2010) 72,000 28 Asthma: 2005-2007 3 Yr Average (95% CI) 12.7% (+/- 0.6) 30 Cancer: Estimated New Cases (2008) 18,900 28 Chlamydia: Rates per 100,000 Population (2007) 361.6 22 Diabetes: 2005-2007 3 Yr Average (95% CI) 5.1% (+/- 0.3) 51 Human West Nile Virus: New Cases (2008) 95 4 Hypertension: 2003-2007 3 Yr Average (95% CI) 21.7% (+/- 0.7) 50 Obesity: 2005-2007 3 Yr Average (95 % CI) 18.4% (+/- 0.7) 51 Syphilis: Rates per 100,000 Population (2007) 1.2 32 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.8% (+/- 0.7) 36 Tuberculosis: Number of Cases (2007) 111 28 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 31 29 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.0% 33 Infant Mortality: Per 1,000 Live Births (2005) 6.4 34 Low Birthweight: % of Total Births (2006) 8.9% 14 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 9.9% 49 Pre-Term Labor: % of Live Births (2006) 12.2% 31 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 109 22 Health Professions Shortage Areas - Mental Health (FY 2008) 34 36 Health Professions Shortage Areas - Dental Care (FY 2008) 71 22 Nursing Shortage Estimates (2010) -10,900 15 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 30,000 26 Potential # of Episodes of Illness During a Severe Pandemic 1,381,000 22 Potential Financial Loss During a Severe Pandemic, % of GDP 5.40% 38 Potential Financial Loss During a Severe Pandemic, $ amount $11.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 33 THE STATE OF YOUR HEALTH: COLORADO Public Health Funding Facts Federal Funding for Colorado’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $17.92 29 Health Resources and Services Administration (HRSA) FY 2008 $21.78 18 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.29 31 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $220,269 Birth Defects and Developmental Disabilities $2,818,588 Cancer $5,611,192 Chronic Disease Prevention and Health Promotion $2,257,353 Diabetes $1,232,097 Environmental Health $530,355 Heart Disease $465,231 HIV/AIDS $9,364,506 Immunization (Sect. 317 and Vaccines for Children Program) $39,164,962 Infectious Diseases $3,258,711 Injury and Violence Prevention $2,651,679 Nutrition and Physical Activity $803,599 Occupational Safety and Health $1,470,095 Pandemic Flu $1,377,824 Preventive Health and Health Services Block Grant $1,476,854 School Health $805,607 Sexually Transmitted Diseases (STD) $2,109,770 Tobacco $1,093,115 Terrorism Preparedness and Emergency Response $11,231,353 Tuberculosis $528,675 Total FY 2008 CDC Dollars (All Categories) $88,522,335 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,904,398 HIV/AIDS $25,582,440 Maternal & Child Health $11,751,614 Primary Health Care $56,669,646 Total FY 2008 HRSA Dollars (All Categories) $105,906,655 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $6,260,449 Total FY 2008 ASPR HPP Dollars $6,260,449 State Spending State Per Capita Funding for Colorado’s Health: $49.62 State Per Capita Funding Ranking:16 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 34 THE STATE OF YOUR HEALTH: CONNECTICUT State Rank* U.S. Census Bureau 2008 Data Total Population 3,501,252 N/A % Uninsured, All Ages 9.4% 45 % Uninsured, 18 and under 5.2% 45 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 20.2% (+/- 0.8) 42 AIDS: Cumulative Cases Aged 13 & Over (2006) 14,716 17 Alzheimer’s Disease: Estimated Cases (2010) 70,000 29 Asthma: 2005-2007 3 Yr Average (95% CI) 13.4% (+/- 0.7) 18 Cancer: Estimated New Cases (2008) 19,190 27 Chlamydia: Rates per 100,000 Population (2007) 326.8 30 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.8% (+/- 0.4) 38 Human West Nile Virus: New Cases (2008) 8 28 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.7% (+/- 0.8) 35 Obesity: 2005-2007 3 Yr Average (95 % CI) 20.8% (+/- 0.8) 49 Syphilis: Rates per 100,000 Population (2007) 1.1 35 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 16.3% (+/- 0.7) 49 Tuberculosis: Number of Cases (2007) 108 29 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 183 12 Asthma: High School Students (2007) 27.4% (+/- 2.5) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 13.2% 48 Infant Mortality: Per 1,000 Live Births (2005) 5.8 40 Low Birthweight: % of Total Births (2006) 8.1% 29 Obesity Rates, % High School Students (2007) 12.3% (+/-1.6) N/A Obesity Rates, % Children Age 10-17 (2004) 12.3% 37 Pre-Term Labor: % of Live Births (2006) 10.4% 48 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 41 43 Health Professions Shortage Areas - Mental Health (FY 2008) 19 44 Health Professions Shortage Areas - Dental Care (FY 2008) 40 37 Nursing Shortage Estimates (2010) -11,100 13 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 29,000 27 Potential # of Episodes of Illness During a Severe Pandemic 1,039,000 29 Potential Financial Loss During a Severe Pandemic, % of GDP 5.23% 46 Potential Financial Loss During a Severe Pandemic, $ amount $10.1 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 35 THE STATE OF YOUR HEALTH: CONNECTICUT Public Health Funding Facts Federal Funding for Connecticut’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $18.63 28 Health Resources and Services Administration (HRSA) FY 2008 $18.89 24 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.36 21 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $415,765 Birth Defects and Developmental Disabilities $183,320 Cancer $2,581,172 Chronic Disease Prevention and Health Promotion $1,825,888 Diabetes $698,159 Environmental Health $2,267,657 Heart Disease $358,925 HIV/AIDS $7,926,823 Immunization (Sect. 317 and Vaccines for Children Program) $29,441,813 Infectious Diseases $3,501,839 Injury and Violence Prevention $1,015,488 Nutrition and Physical Activity $9,000 Occupational Safety and Health $478,121 Pandemic Flu $739,853 Preventive Health and Health Services Block Grant $1,402,350 School Health $569,772 Sexually Transmitted Diseases (STD) $1,068,922 Tobacco $889,343 Terrorism Preparedness and Emergency Response $9,415,983 Tuberculosis $445,901 Total FY 2008 CDC Dollars (All Categories) $65,236,094 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,460,602 HIV/AIDS $30,835,129 Maternal & Child Health $8,461,097 Primary Health Care $21,725,248 Total FY 2008 HRSA Dollars (All Categories) $66,167,554 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $4,747,354 Total FY 2008 ASPR HPP Dollars $4,747,354 State Spending State Per Capita Funding for Connecticut’s Health: $23.44 State Per Capita Funding Ranking:33 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 36 THE STATE OF YOUR HEALTH: DELAWARE State Rank* U.S. Census Bureau 2008 Data Total Population 873,092 N/A % Uninsured, All Ages 11.2% 37 % Uninsured, 18 and under 7.5% 34 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 22.3% (+/- 1.0) 31 AIDS: Cumulative Cases Aged 13 & Over (2006) 3,547 34 Alzheimer’s Disease: Estimated Cases (2010) 14,000 47 Asthma: 2005-2007 3 Yr Average (95% CI) 12.9% (+/- 0.9) 21 Cancer: Estimated New Cases (2008) 4,590 45 Chlamydia: Rates per 100,000 Population (2007) 407.6 15 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.4% (+/- 0.6) 15 Human West Nile Virus: New Cases (2008) 1 39 Hypertension: 2003-2007 3 Yr Average (95% CI) 29.2% (+/- 1.1) 13 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.9% (+/- 1.2) 21 Syphilis: Rates per 100,000 Population (2007) 2.1 25 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.4% (+/- 1.1) 23 Tuberculosis: Number of Cases (2007) 19 43 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 26 33 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 19.7% 42 Infant Mortality: Per 1,000 Live Births (2005) 9.0 6 Low Birthweight: % of Total Births (2006) 9.3% 10 Obesity Rates, % High School Students (2007) 13.3% (+/- 1.6) N/A Obesity Rates, % Children Age 10-17 (2004) 14.8% 19 Pre-Term Labor: % of Live Births (2006) 13.7% 14 Tobacco: Current Smokers High School Students (2007) 24.6% (+/- 2.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 12 51 Health Professions Shortage Areas - Mental Health (FY 2008) 6 51 Health Professions Shortage Areas - Dental Care (FY 2008) 8 50 Nursing Shortage Estimates (2010) -1,300 37 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 6,000 44 Potential # of Episodes of Illness During a Severe Pandemic 250,000 45 Potential Financial Loss During a Severe Pandemic, % of GDP 5.32% 43 Potential Financial Loss During a Severe Pandemic, $ amount $3.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 37 THE STATE OF YOUR HEALTH: DELAWARE Public Health Funding Facts Federal Funding for Delaware’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $24.98 9 Health Resources and Services Administration (HRSA) FY 2008 $20.24 21 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.77 6 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $200,000 Cancer $1,672,974 Chronic Disease Prevention and Health Promotion $209,249 Diabetes $434,003 Environmental Health $247,133 Heart Disease $0 HIV/AIDS $2,384,623 Immunization (Sect. 317 and Vaccines for Children Program) $8,382,092 Infectious Diseases $550,184 Injury and Violence Prevention $938,404 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $122,361 Preventive Health and Health Services Block Grant $181,792 School Health $249,158 Sexually Transmitted Diseases (STD) $545,355 Tobacco $437,770 Terrorism Preparedness and Emergency Response $5,000,000 Tuberculosis $251,018 Total FY 2008 CDC Dollars (All Categories) $21,806,116 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $658,196 HIV/AIDS $6,307,810 Maternal & Child Health $2,798,787 Primary Health Care $5,820,990 Total FY 2008 HRSA Dollars (All Categories) $17,498,587 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,534,297 Total FY 2008 ASPR HPP Dollars $1,534,297 State Spending State Per Capita Funding for Delaware’s Health: $52.54 State Per Capita Funding Ranking:13 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 38 THE STATE OF YOUR HEALTH: DISTRICT OF COLUMBIA State Rank* U.S. Census Bureau 2008 Data Total Population 591,833 N/A % Uninsured, All Ages 9.5% 43 % Uninsured, 18 and under 6.2% 41 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 21.9% (+/- 1.0) 34 AIDS: Cumulative Cases Aged 13 & Over (2006) 17,372 12 Alzheimer’s Disease: Estimated Cases (2010) 9,100 50 Asthma: 2005-2007 3 Yr Average (95% CI) 15.4% (+/- 0.9) 1 Cancer: Estimated New Cases (2008) 2,560 51 Chlamydia: Rates per 100,000 Population (2007) 1036.7 1 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.7% (+/- 0.6) 24 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.9% (+/- 1.2) 20 Obesity: 2005-2007 3 Yr Average (95 % CI) 22.1% (+/- 1.0) 43 Syphilis: Rates per 100,000 Population (2007) 30.6 1 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.4% (+/- 1.0) 39 Tuberculosis: Number of Cases (2007) 60 34 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 189 11 Asthma: High School Students (2007) 26.1 (+/- 2.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 18.4% 46 Infant Mortality: Per 1,000 Live Births (2005) 14.0 1 Low Birthweight: % of Total Births (2006) 11.5% 2 Obesity Rates, % High School Students (2007) 17.7% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 22.8% 1 Pre-Term Labor: % of Live Births (2006) 16.0% 4 Tobacco: Current Smokers High School Students (2007) 12.8 (+/- 2.1) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 14 50 Health Professions Shortage Areas - Mental Health (FY 2008) 8 50 Health Professions Shortage Areas - Dental Care (FY 2008) 8 50 Nursing Shortage Estimates (2010) -3,000 30 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 5,000 47 Potential # of Episodes of Illness During a Severe Pandemic 162,000 50 Potential Financial Loss During a Severe Pandemic, % of GDP 4.62% 51 Potential Financial Loss During a Severe Pandemic, $ amount $3.8 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 39 THE STATE OF YOUR HEALTH: DISTRICT OF COLUMBIA Public Health Funding Facts Federal Funding for District of Columbia’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $NA* 0 Health Resources and Services Administration (HRSA) FY 2008 *NA 0 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 *NA 0 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $1,088,316 Birth Defects and Developmental Disabilities $9,653,026 Cancer $3,282,298 Chronic Disease Prevention and Health Promotion $10,907,190 Diabetes $2,099,093 Environmental Health $4,900,987 Heart Disease $1,040,684 HIV/AIDS $21,320,023 Immunization (Sect. 317 and Vaccines for Children Program) $9,630,009 Infectious Diseases $3,865,932 Injury and Violence Prevention $1,443,710 Nutrition and Physical Activity $1,443,433 Occupational Safety and Health $1,918,309 Pandemic Flu $741,314 Preventive Health and Health Services Block Grant $1,402,350 School Health $4,691,281 Sexually Transmitted Diseases (STD) $2,885,695 Tobacco $551,846 Terrorism Preparedness and Emergency Response $13,654,074 Tuberculosis $804,826 Total FY 2008 CDC Dollars (All Categories) $98,964,121 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $3,351,874 HIV/AIDS $74,843,002 Maternal & Child Health $24,828,041 Primary Health Care $11,224,929 Total FY 2008 HRSA Dollars (All Categories) $116,323,431 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,707,585 Total FY 2008 ASPR HPP Dollars $1,707,585 State Spending State Per Capita Funding for DC’s Health: $115.08 State Per Capita Funding Ranking:3 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 40 THE STATE OF YOUR HEALTH: FLORIDA State Rank* U.S. Census Bureau 2008 Data Total Population 18,328,340 N/A % Uninsured, All Ages 20.2% 3 % Uninsured, 18 and under 19.2% 2 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 25.8% (+/- 0.7) 13 AIDS: Cumulative Cases Aged 13 & Over (2006) 104,084 3 Alzheimer’s Disease: Estimated Cases (2010) 450,000 2 Asthma: 2005-2007 3 Yr Average (95% CI) 11.3% (+/- 0.5) 44 Cancer: Estimated New Cases (2008) 101,920 2 Chlamydia: Rates per 100,000 Population (2007) 318.3 32 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.7% (+/- 0.4) 12 Human West Nile Virus: New Cases (2008) 2 37 Hypertension: 2003-2007 3 Yr Average (95% CI) 29.3% (+/- 0.9) 12 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.3% (+/- 0.7) 40 Syphilis: Rates per 100,000 Population (2007) 5.0 9 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.6% (+/- 0.7) 22 Tuberculosis: Number of Cases (2007) 989 4 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 1530 2 Asthma: High School Students (2007) 19.6% (+/- 1.4) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 19.7% 42 Infant Mortality: Per 1,000 Live Births (2005) 7.2 22 Low Birthweight: % of Total Births (2006) 8.7% 18 Obesity Rates, % High School Students (2007) 11.2% (+/- 1.4) N/A Obesity Rates, % Children Age 10-17 (2004) 14.4% 21 Pre-Term Labor: % of Live Births (2006) 13.8% 13 Tobacco: Current Smokers High School Students (2007) 20.2% (+/- 1.6) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 241 4 Health Professions Shortage Areas - Mental Health (FY 2008) 132 3 Health Professions Shortage Areas - Dental Care (FY 2008) 200 3 Nursing Shortage Estimates (2010) -32,700 3 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 149,000 3 Potential # of Episodes of Illness During a Severe Pandemic 5,254,000 4 Potential Financial Loss During a Severe Pandemic, % of GDP 5.74% 14 Potential Financial Loss During a Severe Pandemic, $ amount $38.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 41 THE STATE OF YOUR HEALTH: FLORIDA Public Health Funding Facts Federal Funding for Florida’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $13.29 47 Health Resources and Services Administration (HRSA) FY 2008 $19.57 22 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.23 46 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $545,503 Birth Defects and Developmental Disabilities $1,330,963 Cancer $6,716,018 Chronic Disease Prevention and Health Promotion $2,789,582 Diabetes $666,596 Environmental Health $2,352,837 Heart Disease $1,055,703 HIV/AIDS $34,550,088 Immunization (Sect. 317 and Vaccines for Children Program) $140,853,876 Infectious Diseases $1,368,230 Injury and Violence Prevention $2,493,462 Nutrition and Physical Activity $0 Occupational Safety and Health $1,538,467 Pandemic Flu $1,411,187 Preventive Health and Health Services Block Grant $3,082,934 School Health $1,517,512 Sexually Transmitted Diseases (STD) $4,062,320 Tobacco $528,750 Terrorism Preparedness and Emergency Response $29,669,053 Tuberculosis $7,030,192 Total FY 2008 CDC Dollars (All Categories) $243,563,273 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $11,687,847 HIV/AIDS $210,290,287 Maternal & Child Health $26,478,858 Primary Health Care $93,978,530 Total FY 2008 HRSA Dollars (All Categories) $357,249,277 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $22,422,494 Total FY 2008 ASPR HPP Dollars $22,422,494 State Spending State Per Capita Funding for Florida’s Health: $29.89 State Per Capita Funding Ranking:27 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 42 THE STATE OF YOUR HEALTH: GEORGIA State Rank* U.S. Census Bureau 2008 Data Total Population 9,685,744 N/A % Uninsured, All Ages 17.5% 10 % Uninsured, 18 and under 11.5% 14 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 25.5% (+/- 0.9) 14 AIDS: Cumulative Cases Aged 13 & Over (2006) 31,734 8 Alzheimer’s Disease: Estimated Cases (2010) 120,000 12 Asthma: 2005-2007 3 Yr Average (95% CI) 12.2% (+/- 0.7) 35 Cancer: Estimated New Cases (2008) 36,980 11 Chlamydia: Rates per 100,000 Population (2007) 458.3 7 Diabetes: 2005-2007 3 Yr Average (95% CI) 9.2% (+/- 0.5) 9 Human West Nile Virus: New Cases (2008) 8 28 Hypertension: 2003-2007 3 Yr Average (95% CI) 29.4% (+/- 0.8) 11 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.5% (+/- 0.9) 11 Syphilis: Rates per 100,000 Population (2007) 7.3 4 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.4% (+/- 0.9) 24 Tuberculosis: Number of Cases (2007) 474 6 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 231 9 Asthma: High School Students (2007) 22.1% (+/- 2.1) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 20.4% 41 Infant Mortality: Per 1,000 Live Births (2005) 8.2 10 Low Birthweight: % of Total Births (2006) 9.6% 7 Obesity Rates, % High School Students (2007) 13.8% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 16.4% 12 Pre-Term Labor: % of Live Births (2006) 14.1% 9 Tobacco: Current Smokers High School Students (2007) 26.2% (+/- 2.3) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 186 7 Health Professions Shortage Areas - Mental Health (FY 2008) 61 14 Health Professions Shortage Areas - Dental Care (FY 2008) 135 5 Nursing Shortage Estimates (2010) -16,400 8 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 57,000 11 Potential # of Episodes of Illness During a Severe Pandemic 2,688,000 9 Potential Financial Loss During a Severe Pandemic, % of GDP 5.46% 31 Potential Financial Loss During a Severe Pandemic, $ amount $19.8 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 43 THE STATE OF YOUR HEALTH: GEORGIA Public Health Funding Facts Federal Funding for Georgia’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $18.68 27 Health Resources and Services Administration (HRSA) FY 2008 $16.08 33 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.24 44 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $1,084,020 Birth Defects and Developmental Disabilities $1,106,356 Cancer $8,079,543 Chronic Disease Prevention and Health Promotion $12,938,355 Diabetes $1,096,787 Environmental Health $2,663,059 Heart Disease $4,234,672 HIV/AIDS $14,392,413 Immunization (Sect. 317 and Vaccines for Children Program) $87,766,437 Infectious Diseases $4,079,836 Injury and Violence Prevention $2,704,239 Nutrition and Physical Activity $1,066,687 Occupational Safety and Health $450,063 Pandemic Flu $5,138,480 Preventive Health and Health Services Block Grant $3,012,467 School Health $530,619 Sexually Transmitted Diseases (STD) $3,914,273 Tobacco $901,944 Terrorism Preparedness and Emergency Response $21,724,929 Tuberculosis $2,445,792 Total FY 2008 CDC Dollars (All Categories) $180,956,083 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $7,159,079 HIV/AIDS $71,988,152 Maternal & Child Health $23,081,280 Primary Health Care $44,214,244 Total FY 2008 HRSA Dollars (All Categories) $153,462,033 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $11,847,828 Total FY 2008 ASPR HPP Dollars $11,847,828 State Spending State Per Capita Funding for Georgia’s Health: $18.33 State Per Capita Funding Ranking:39 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 44 THE STATE OF YOUR HEALTH: HAWAII State Rank* zU.S. Census Bureau 2008 Data Total Population 1,288,198 N/A % Uninsured, All Ages 7.5% 50 % Uninsured, 18 and under 4.8% 48 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 18.9% (+/- 0.8) 46 AIDS: Cumulative Cases Aged 13 & Over (2006) 2,927 35 Alzheimer’s Disease: Estimated Cases (2010) 27,000 39 Asthma: 2005-2007 3 Yr Average (95% CI) 14.7% (+/- 0.8) 5 Cancer: Estimated New Cases (2008) 6,310 42 Chlamydia: Rates per 100,000 Population (2007) 440.2 10 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.7% (+/- 0.5) 25 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 26.1% (+/- 0.9) 30 Obesity: 2005-2007 3 Yr Average (95 % CI) 20.7% (+/- 0.8) 50 Syphilis: Rates per 100,000 Population (2007) 0.7 44 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 17.2% (+/- 0.8) 47 Tuberculosis: Number of Cases (2007) 122 25 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 17 37 Asthma: High School Students (2007) 28.7% (+/- 3.4) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 12.5% 49 Infant Mortality: Per 1,000 Live Births (2005) 6.5 32 Low Birthweight: % of Total Births (2006) 8.1% 29 Obesity Rates, % High School Students (2007) 15.6% (+/- 2.9) N/A Obesity Rates, % Children Age 10-17 (2004) 13.3% 29 Pre-Term Labor: % of Live Births (2006) 12.1% 32 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 31 46 Health Professions Shortage Areas - Mental Health (FY 2008) 28 40 Health Professions Shortage Areas - Dental Care (FY 2008) 27 43 Nursing Shortage Estimates (2010) -4,500 23 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 10,000 39 Potential # of Episodes of Illness During a Severe Pandemic 365,000 42 Potential Financial Loss During a Severe Pandemic, % of GDP 6.60% 2 Potential Financial Loss During a Severe Pandemic, $ amount $3.6 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 45 THE STATE OF YOUR HEALTH: HAWAII Public Health Funding Facts Federal Funding for Hawaii’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $25.55 8 Health Resources and Services Administration (HRSA) FY 2008 $32.09 8 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.60 9 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $278,673 Cancer $2,275,167 Chronic Disease Prevention and Health Promotion $1,701,355 Diabetes $1,369,038 Environmental Health $440,000 Heart Disease $330,113 HIV/AIDS $2,657,394 Immunization (Sect. 317 and Vaccines for Children Program) $12,345,405 Infectious Diseases $569,840 Injury and Violence Prevention $1,278,224 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $1,546,194 Preventive Health and Health Services Block Grant $751,610 School Health $375,427 Sexually Transmitted Diseases (STD) $366,490 Tobacco $763,562 Terrorism Preparedness and Emergency Response $4,997,077 Tuberculosis $873,515 Total FY 2008 CDC Dollars (All Categories) $32,919,084 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $3,830,117 HIV/AIDS $3,681,098 Maternal & Child Health $4,998,708 Primary Health Care $26,201,503 Total FY 2008 HRSA Dollars (All Categories) $41,186,239 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,057,849 Total FY 2008 ASPR HPP Dollars $2,057,849 State Spending State Per Capita Funding for Hawaii’s Health: $172.21 State Per Capita Funding Ranking:1 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 46 THE STATE OF YOUR HEALTH: IDAHO State Rank* U.S. Census Bureau 2008 Data Total Population 1,523,816 N/A % Uninsured, All Ages 13.9% 22 % Uninsured, 18 and under 11.0% 16 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 20.6% (+/- 0.8) 40 AIDS: Cumulative Cases Aged 13 & Over (2006) 604 46 Alzheimer’s Disease: Estimated Cases (2010) 26,000 40 Asthma: 2005-2007 3 Yr Average (95% CI) 12.7% (+/- 0.7) 28 Cancer: Estimated New Cases (2008) 6,430 41 Chlamydia: Rates per 100,000 Population (2007) 253.8 42 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.2% (+/- 0.5) 33 Human West Nile Virus: New Cases (2008) 33 12 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.4% (+/- 0.9) 39 Obesity: 2005-2007 3 Yr Average (95 % CI) 24.6% (+/- 0.9) 31 Syphilis: Rates per 100,000 Population (2007) 0.1 51 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.0% (+/- 0.9) 42 Tuberculosis: Number of Cases (2007) 9 48 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 2 49 Asthma: High School Students (2007) 18.5% (+/- 2.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 34.4% 3 Infant Mortality: Per 1,000 Live Births (2005) 6.1 35 Low Birthweight: % of Total Births (2006) 6.9% 39 Obesity Rates, % High School Students (2007) 11.1% (+/- 1.7) N/A Obesity Rates, % Children Age 10-17 (2004) 10.1% 47 Pre-Term Labor: % of Live Births (2006) 11.6% 38 Tobacco: Current Smokers High School Students (2007) 26.1% (+/- 4.1) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 67 39 Health Professions Shortage Areas - Mental Health (FY 2008) 24 42 Health Professions Shortage Areas - Dental Care (FY 2008) 60 30 Nursing Shortage Estimates (2010) -800 41 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 9,000 43 Potential # of Episodes of Illness During a Severe Pandemic 425,000 39 Potential Financial Loss During a Severe Pandemic, % of GDP 5.42% 35 Potential Financial Loss During a Severe Pandemic, $ amount $2.6 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 47 THE STATE OF YOUR HEALTH: IDAHO Public Health Funding Facts Federal Funding for Idaho’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $20.97 18 Health Resources and Services Administration (HRSA) FY 2008 $19.43 23 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.52 12 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $183,331 Birth Defects and Developmental Disabilities $0 Cancer $2,279,043 Chronic Disease Prevention and Health Promotion $569,661 Diabetes $340,881 Environmental Health $334,999 Heart Disease $343,456 HIV/AIDS $970,580 Immunization (Sect. 317 and Vaccines for Children Program) $18,546,460 Infectious Diseases $524,151 Injury and Violence Prevention $177,987 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $97,458 Preventive Health and Health Services Block Grant $360,505 School Health $507,489 Sexually Transmitted Diseases (STD) $394,478 Tobacco $936,825 Terrorism Preparedness and Emergency Response $5,214,010 Tuberculosis $176,843 Total FY 2008 CDC Dollars (All Categories) $31,958,157 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $761,378 HIV/AIDS $2,076,203 Maternal & Child Health $3,925,550 Primary Health Care $18,072,737 Total FY 2008 HRSA Dollars (All Categories) $29,134,290 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,277,157 Total FY 2008 ASPR HPP Dollars $2,277,157 State Spending State Per Capita Funding for Idaho’s Health: $78.29 State Per Capita Funding Ranking:5 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 48 THE STATE OF YOUR HEALTH: ILLINOIS State Rank* U.S. Census Bureau 2008 Data Total Population 12,901,563 N/A % Uninsured, All Ages 13.4% 26 % Uninsured, 18 and under 6.6% 38 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 23.7% (+/- 0.9) 22 AIDS: Cumulative Cases Aged 13 & Over (2006) 33,620 6 Alzheimer’s Disease: Estimated Cases (2010) 210,000 7 Asthma: 2005-2007 3 Yr Average (95% CI) 12.1% (+/- 0.7) 38 Cancer: Estimated New Cases (2008) 59,130 6 Chlamydia: Rates per 100,000 Population (2007) 432.3 11 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.3% (+/- 0.5) 17 Human West Nile Virus: New Cases (2008) 19 17 Hypertension: 2003-2007 3 Yr Average (95% CI) 26.7% (+/- 0.9) 28 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.3% (+/- 0.9) 26 Syphilis: Rates per 100,000 Population (2007) 3.6 16 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.2% (+/- 0.9) 26 Tuberculosis: Number of Cases (2007) 521 5 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 282 8 Asthma: High School Students (2007) 20.0% (+/- 2.2) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 26.5% 11 Infant Mortality: Per 1,000 Live Births (2005) 7.4 18 Low Birthweight: % of Total Births (2006) 8.6% 19 Obesity Rates, % High School Students (2007) 12.9% (+/- 2.1) N/A Obesity Rates, % Children Age 10-17 (2004) 15.8% 14 Pre-Term Labor: % of Live Births (2006) 13.3% 19 Tobacco: Current Smokers High School Students (2007) 25.3% (+/- 3.3) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 266 3 Health Professions Shortage Areas - Mental Health (FY 2008) 117 5 Health Professions Shortage Areas - Dental Care (FY 2008) 167 4 Nursing Shortage Estimates (2010) -9,300 16 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 99,000 6 Potential # of Episodes of Illness During a Severe Pandemic 3,787,000 5 Potential Financial Loss During a Severe Pandemic, % of GDP 5.60% 21 Potential Financial Loss During a Severe Pandemic, $ amount $31.3 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 49 THE STATE OF YOUR HEALTH: ILLINOIS Public Health Funding Facts Federal Funding for Illinois’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $16.66 33 Health Resources and Services Administration (HRSA) FY 2008 $17.21 28 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $0.98 48 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $813,823 Birth Defects and Developmental Disabilities $2,493,057 Cancer $9,416,948 Chronic Disease Prevention and Health Promotion $8,452,918 Diabetes $1,303,845 Environmental Health $2,971,683 Heart Disease $590,711 HIV/AIDS $19,580,704 Immunization (Sect. 317 and Vaccines for Children Program) $116,560,206 Infectious Diseases $2,953,879 Injury and Violence Prevention $3,660,418 Nutrition and Physical Activity $0 Occupational Safety and Health $1,156,606 Pandemic Flu $1,624,625 Preventive Health and Health Services Block Grant $2,809,162 School Health $625,881 Sexually Transmitted Diseases (STD) $4,279,316 Tobacco $972,977 Terrorism Preparedness and Emergency Response $31,716,374 Tuberculosis $2,928,553 Total FY 2008 CDC Dollars (All Categories) $214,962,853 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $7,534,874 HIV/AIDS $76,758,136 Maternal & Child Health $37,431,749 Primary Health Care $84,801,725 Total FY 2008 HRSA Dollars (All Categories) $221,165,510 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $12,605,863 Total FY 2008 ASPR HPP Dollars $12,605,863 State Spending State Per Capita Funding for Illinois’s Health: $23.47 State Per Capita Funding Ranking:32 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 50 THE STATE OF YOUR HEALTH: INDIANA State Rank* U.S. Census Bureau 2008 Data Total Population 6,376,792 N/A % Uninsured, All Ages 11.4% 35 % Uninsured, 18 and under 5.2% 45 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 25.5% (+/- 0.8) 15 AIDS: Cumulative Cases Aged 13 & Over (2006) 8,239 25 Alzheimer’s Disease: Estimated Cases (2010) 120,000 12 Asthma: 2005-2007 3 Yr Average (95% CI) 12.9% (+/- 0.7) 23 Cancer: Estimated New Cases (2008) 29,550 15 Chlamydia: Rates per 100,000 Population (2007) 328.1 29 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.3% (+/- 0.5) 17 Human West Nile Virus: New Cases (2008) 3 35 Hypertension: 2003-2007 3 Yr Average (95% CI) 28.1% (+/-0.8) 19 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.5% (+/- 0.9) 11 Syphilis: Rates per 100,000 Population (2007) 0.9 39 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 25.1% (+/- 0.9) 4 Tuberculosis: Number of Cases (2007) 128 24 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 56 22 Asthma: High School Students (2007) 22.5% (+/- 3.0) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 26.0% 13 Infant Mortality: Per 1,000 Live Births (2005) 8.0 13 Low Birthweight: % of Total Births (2006) 8.2% 28 Obesity Rates, % High School Students (2007) 13.8% (+/-2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 15.6% 15 Pre-Term Labor: % of Live Births (2006) 13.2% 21 Tobacco: Current Smokers High School Students (2007) 29.3% (+/- 4.8) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 97 26 Health Professions Shortage Areas - Mental Health (FY 2008) 45 27 Health Professions Shortage Areas - Dental Care (FY 2008) 38 38 Nursing Shortage Estimates (2010) -8,200 18 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 49,000 14 Potential # of Episodes of Illness During a Severe Pandemic 1,863,000 14 Potential Financial Loss During a Severe Pandemic, % of GDP 5.87% 10 Potential Financial Loss During a Severe Pandemic, $ amount $14.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 51 THE STATE OF YOUR HEALTH: INDIANA Public Health Funding Facts Federal Funding for Indiana’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $12.74 50 Health Resources and Services Administration (HRSA) FY 2008 $10.32 49 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.28 35 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $70,000 Birth Defects and Developmental Disabilities $212,200 Cancer $2,890,479 Chronic Disease Prevention and Health Promotion $1,072,606 Diabetes $901,526 Environmental Health $1,334,164 Heart Disease $44,021 HIV/AIDS $4,132,659 Immunization (Sect. 317 and Vaccines for Children Program) $48,954,614 Infectious Diseases $675,772 Injury and Violence Prevention $827,452 Nutrition and Physical Activity $485,377 Occupational Safety and Health $214,220 Pandemic Flu $910,119 Preventive Health and Health Services Block Grant $1,636,601 School Health $577,845 Sexually Transmitted Diseases (STD) $1,651,931 Tobacco $855,124 Terrorism Preparedness and Emergency Response $13,094,801 Tuberculosis $652,709 Total FY 2008 CDC Dollars (All Categories) $81,208,839 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $3,741,556 HIV/AIDS $17,714,573 Maternal & Child Health $15,877,859 Primary Health Care $22,213,754 Total FY 2008 HRSA Dollars (All Categories) $65,480,314 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $8,151,131 Total FY 2008 ASPR HPP Dollars $8,151,131 State Spending State Per Capita Funding for Indiana’s Health: $15.40 State Per Capita Funding Ranking:45 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 52 THE STATE OF YOUR HEALTH: IOWA State Rank* U.S. Census Bureau 2008 Data Total Population 3,002,555 N/A % Uninsured, All Ages 9.3% 46 % Uninsured, 18 and under 4.8% 48 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 23.0% (+/- 0.8) 25 AIDS: Cumulative Cases Aged 13 & Over (2006) 1,727 40 Alzheimer’s Disease: Estimated Cases (2010) 69,000 30 Asthma: 2005-2007 3 Yr Average (95% CI) 10.5% (+/- 0.6) 50 Cancer: Estimated New Cases (2008) 16,150 30 Chlamydia: Rates per 100,000 Population (2007) 289.8 38 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.0% (+/- 0.5) 35 Human West Nile Virus: New Cases (2008) 10 25 Hypertension: 2003-2007 3 Yr Average (95% CI) 26.3% (+/- 0.8) 29 Obesity: 2005-2007 3 Yr Average (95 % CI) 26.3% (+/- 0.9) 19 Syphilis: Rates per 100,000 Population (2007) 0.7 44 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.6% (+/- 0.9) 20 Tuberculosis: Number of Cases (2007) 43 39 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 13 39 Asthma: High School Students (2007) 15.4% (+/- 2.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 24.1% 18 Infant Mortality: Per 1,000 Live Births (2005) 5.3 44 Low Birthweight: % of Total Births (2006) 6.9% 39 Obesity Rates, % High School Students (2007) 11.3% (+/- 3.1) N/A Obesity Rates, % Children Age 10-17 (2004) 12.5% 35 Pre-Term Labor: % of Live Births (2006) 11.6% 38 Tobacco: Current Smokers High School Students (2007) 25.5% (+/- 3.9) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 90 30 Health Professions Shortage Areas - Mental Health (FY 2008) 35 35 Health Professions Shortage Areas - Dental Care (FY 2008) 100 15 Nursing Shortage Estimates (2010) -3,400 26 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 26,000 30 Potential # of Episodes of Illness During a Severe Pandemic 878,000 30 Potential Financial Loss During a Severe Pandemic, % of GDP 5.90% 9 Potential Financial Loss During a Severe Pandemic, $ amount $6.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 53 THE STATE OF YOUR HEALTH: IOWA Public Health Funding Facts Federal Funding for Iowa’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $16.37 34 Health Resources and Services Administration (HRSA) FY 2008 $16.43 32 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.38 17 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $212,480 Birth Defects and Developmental Disabilities $3,118,989 Cancer $3,589,614 Chronic Disease Prevention and Health Promotion $698,180 Diabetes $236,424 Environmental Health $1,494,232 Heart Disease $345,000 HIV/AIDS $1,951,898 Immunization (Sect. 317 and Vaccines for Children Program) $19,856,622 Infectious Diseases $971,657 Injury and Violence Prevention $1,800,086 Nutrition and Physical Activity $842,721 Occupational Safety and Health $1,800,077 Pandemic Flu $428,414 Preventive Health and Health Services Block Grant $1,301,894 School Health $229,677 Sexually Transmitted Diseases (STD) $716,072 Tobacco $833,761 Terrorism Preparedness and Emergency Response $8,340,941 Tuberculosis $391,826 Total FY 2008 CDC Dollars (All Categories) $49,160,565 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,085,264 HIV/AIDS $4,434,558 Maternal & Child Health $8,809,054 Primary Health Care $17,902,725 Total FY 2008 HRSA Dollars (All Categories) $49,097,111 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $4,113,883 Total FY 2008 ASPR HPP Dollars $4,113,883 State Spending State Per Capita Funding for Iowa’s Health: $19.50 State Per Capita Funding Ranking:37 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 54 THE STATE OF YOUR HEALTH: KANSAS State Rank* U.S. Census Bureau 2008 Data Total Population 2,802,134 N/A % Uninsured, All Ages 12.7% 30 % Uninsured, 18 and under 7.7% 33 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 23.3% (+/- 0.7) 24 AIDS: Cumulative Cases Aged 13 & Over (2006) 2,781 36 Alzheimer’s Disease: Estimated Cases (2010) 53,000 32 Asthma: 2005-2007 3 Yr Average (95% CI) 11.7% (+/- 0.6) 42 Cancer: Estimated New Cases (2008) 12,520 33 Chlamydia: Rates per 100,000 Population (2007) 295.9 34 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.2% (+/- 0.4) 34 Human West Nile Virus: New Cases (2008) 38 10 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.6% (+/- 0.7) 36 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.8% (+/- 0.7) 23 Syphilis: Rates per 100,000 Population (2007) 1.0 37 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.6% (+/- 0.7) 38 Tuberculosis: Number of Cases (2007) 59 35 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 14 38 Asthma: High School Students (2007) 20.1% (+/- 2.5) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 24.0% 19 Infant Mortality: Per 1,000 Live Births (2005) 7.4 18 Low Birthweight: % of Total Births (2006) 7.2% 35 Obesity Rates, % High School Students (2007) 11.1% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 14.0% 24 Pre-Term Labor: % of Live Births (2006) 11.8% 36 Tobacco: Current Smokers High School Students (2007) 25.2% (+/- 2.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 144 11 Health Professions Shortage Areas - Mental Health (FY 2008) 44 28 Health Professions Shortage Areas - Dental Care (FY 2008) 114 10 Nursing Shortage Estimates (2010) -1,000 39 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 22,000 33 Potential # of Episodes of Illness During a Severe Pandemic 810,000 33 Potential Financial Loss During a Severe Pandemic, % of GDP 5.58% 22 Potential Financial Loss During a Severe Pandemic, $ amount $5.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 55 THE STATE OF YOUR HEALTH: KANSAS Public Health Funding Facts Federal Funding for Kansas’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.14 41 Health Resources and Services Administration (HRSA) FY 2008 $9.96 50 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.39 16 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $545,000 Cancer $3,514,512 Chronic Disease Prevention and Health Promotion $1,113,298 Diabetes $748,667 Environmental Health $280,994 Heart Disease $537,088 HIV/AIDS $2,004,116 Immunization (Sect. 317 and Vaccines for Children Program) $19,993,820 Infectious Diseases $735,234 Injury and Violence Prevention $901,144 Nutrition and Physical Activity $119,787 Occupational Safety and Health $387,700 Pandemic Flu $96,895 Preventive Health and Health Services Block Grant $911,765 School Health $257,997 Sexually Transmitted Diseases (STD) $788,485 Tobacco $1,026,429 Terrorism Preparedness and Emergency Response $7,659,039 Tuberculosis $397,590 Total FY 2008 CDC Dollars (All Categories) $42,419,311 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $2,352,127 HIV/AIDS $4,248,658 Maternal & Child Health $7,034,385 Primary Health Care $9,166,608 Total FY 2008 HRSA Dollars (All Categories) $27,646,209 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $3,849,684 Total FY 2008 ASPR HPP Dollars $3,849,684 State Spending State Per Capita Funding for Kansas’s Health: $18.87 State Per Capita Funding Ranking:38 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 56 THE STATE OF YOUR HEALTH: KENTUCKY State Rank* U.S. Census Bureau 2008 Data Total Population 4,269,245 N/A % Uninsured, All Ages 13.6% 24 % Uninsured, 18 and under 8.0% 30 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 30.7% (+/- 1.0) 4 AIDS: Cumulative Cases Aged 13 & Over (2006) 4,600 31 Alzheimer’s Disease: Estimated Cases (2010) 80,000 24 Asthma: 2005-2007 3 Yr Average (95% CI) 12.5% (+/- 0.8) 32 Cancer: Estimated New Cases (2008) 23,270 22 Chlamydia: Rates per 100,000 Population (2007) 209.2 47 Diabetes: 2005-2007 3 Yr Average (95% CI) 9.6% (+/- 0.6) 7 Human West Nile Virus: New Cases (2008) 3 35 Hypertension: 2003-2007 3 Yr Average (95% CI) 30.1% (+/- 0.9) 9 Obesity: 2005-2007 3 Yr Average (95 % CI) 28.4% (+/- 1.0) 7 Syphilis: Rates per 100,000 Population (2007) 1.3 31 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 28.5% (+/- 1.0) 1 Tuberculosis: Number of Cases (2007) 120 26 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 32 28 Asthma: High School Students (2007) 26.1% (+/- 1.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 21.8% 34 Infant Mortality: Per 1,000 Live Births (2005) 6.6 29 Low Birthweight: % of Total Births (2006) 9.1% 12 Obesity Rates, % High School Students (2007) 15.6% (+/- 1.7) N/A Obesity Rates, % Children Age 10-17 (2004) 20.6% 3 Pre-Term Labor: % of Live Births (2006) 15.1% 6 Tobacco: Current Smokers High School Students (2007) 33.6% (+/- 2.8) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 136 14 Health Professions Shortage Areas - Mental Health (FY 2008) 78 11 Health Professions Shortage Areas - Dental Care (FY 2008) 57 32 Nursing Shortage Estimates (2010) 1,200 51 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 33,000 24 Potential # of Episodes of Illness During a Severe Pandemic 1,232,000 26 Potential Financial Loss During a Severe Pandemic, % of GDP 5.87% 10 Potential Financial Loss During a Severe Pandemic, $ amount $8.2 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 57 THE STATE OF YOUR HEALTH: KENTUCKY Public Health Funding Facts Federal Funding for Kentucky’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $13.94 46 Health Resources and Services Administration (HRSA) FY 2008 $16.77 31 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.32 26 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $150,882 Cancer $3,849,463 Chronic Disease Prevention and Health Promotion $1,135,000 Diabetes $611,989 Environmental Health $450,085 Heart Disease $340,000 HIV/AIDS $2,584,182 Immunization (Sect. 317 and Vaccines for Children Program) $34,035,141 Infectious Diseases $546,977 Injury and Violence Prevention $1,025,303 Nutrition and Physical Activity $0 Occupational Safety and Health $407,497 Pandemic Flu $124,770 Preventive Health and Health Services Block Grant $1,517,216 School Health $372,250 Sexually Transmitted Diseases (STD) $931,070 Tobacco $939,064 Terrorism Preparedness and Emergency Response $9,684,300 Tuberculosis $827,262 Total FY 2008 CDC Dollars (All Categories) $59,532,451 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,239,240 HIV/AIDS $10,706,646 Maternal & Child Health $14,231,416 Primary Health Care $26,484,995 Total FY 2008 HRSA Dollars (All Categories) $71,120,810 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $5,597,192 Total FY 2008 ASPR HPP Dollars $5,597,192 State Spending State Per Capita Funding for Kentucky’s Health: $42.40 State Per Capita Funding Ranking:19 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 58 THE STATE OF YOUR HEALTH: LOUISIANA State Rank* U.S. Census Bureau 2008 Data Total Population 4,410,796 N/A % Uninsured, All Ages 18.5% 5 % Uninsured, 18 and under 12.5% 11 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 31.4% (+/- 1.0) 2 AIDS: Cumulative Cases Aged 13 & Over (2006) 17,612 11 Alzheimer’s Disease: Estimated Cases (2010) 83,000 23 Asthma: 2005-2007 3 Yr Average (95% CI) 10.5% (+/- 0.7) 49 Cancer: Estimated New Cases (2008) 23,360 21 Chlamydia: Rates per 100,000 Population (2007) 451.6 8 Diabetes: 2005-2007 3 Yr Average (95% CI) 9.5% (+/- 0.5) 8 Human West Nile Virus: New Cases (2008) 36 11 Hypertension: 2003-2007 3 Yr Average (95% CI) 30.9% (+/- 1.0) 7 Obesity: 2005-2007 3 Yr Average (95 % CI) 29.5% (+/- 1.0) 4 Syphilis: Rates per 100,000 Population (2007) 12.4 2 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 22.9% (+/- 0.9) 11 Tuberculosis: Number of Cases (2007) 218 19 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 128 15 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 23.0% 23 Infant Mortality: Per 1,000 Live Births (2005) 10.1 3 Low Birthweight: % of Total Births (2006) 11.3% 3 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 17.2% 9 Pre-Term Labor: % of Live Births (2006) 16.4% 3 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 120 15 Health Professions Shortage Areas - Mental Health (FY 2008) 62 13 Health Professions Shortage Areas - Dental Care (FY 2008) 80 19 Nursing Shortage Estimates (2010) 100 48 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 35,000 23 Potential # of Episodes of Illness During a Severe Pandemic 1,339,000 24 Potential Financial Loss During a Severe Pandemic, % of GDP 6.03% 6 Potential Financial Loss During a Severe Pandemic, $ amount $10.1 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 59 THE STATE OF YOUR HEALTH: LOUISIANA Public Health Funding Facts Federal Funding for Louisiana’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $21.25 16 Health Resources and Services Administration (HRSA) FY 2008 $24.15 13 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.33 24 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $383,001 Birth Defects and Developmental Disabilities $407,050 Cancer $2,376,484 Chronic Disease Prevention and Health Promotion $1,315,403 Diabetes $105,483 Environmental Health $716,115 Heart Disease $293,628 HIV/AIDS $11,100,991 Immunization (Sect. 317 and Vaccines for Children Program) $57,255,436 Infectious Diseases $887,517 Injury and Violence Prevention $733,017 Nutrition and Physical Activity $0 Occupational Safety and Health $157,878 Pandemic Flu $596,852 Preventive Health and Health Services Block Grant $2,797,953 School Health $283,883 Sexually Transmitted Diseases (STD) $1,490,819 Tobacco $907,923 Terrorism Preparedness and Emergency Response $10,415,739 Tuberculosis $1,296,991 Total FY 2008 CDC Dollars (All Categories) $93,735,053 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $6,536,303 HIV/AIDS $44,083,719 Maternal & Child Health $17,880,295 Primary Health Care $28,271,136 Total FY 2008 HRSA Dollars (All Categories) $103,663,693 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $5,696,194 Total FY 2008 ASPR HPP Dollars $5,696,194 State Spending State Per Capita Funding for Louisiana’s Health: $48.21 State Per Capita Funding Ranking:17 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 60 THE STATE OF YOUR HEALTH: MAINE State Rank* U.S. Census Bureau 2008 Data Total Population 1,316,456 N/A % Uninsured, All Ages 8.8% 47 % Uninsured, 18 and under 5.1% 47 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 21.1% (+/- 0.9) 38 AIDS: Cumulative Cases Aged 13 & Over (2006) 1,110 43 Alzheimer’s Disease: Estimated Cases (2010) 25,000 41 Asthma: 2005-2007 3 Yr Average (95% CI) 14.7% (+/- 0.8) 5 Cancer: Estimated New Cases (2008) 8,140 38 Chlamydia: Rates per 100,000 Population (2007) 192.3 48 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.4% (+/- 0.5) 30 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.6% (+/- 1.0) 22 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.7% (+/- 0.9) 34 Syphilis: Rates per 100,000 Population (2007) 0.7 44 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.6% (+/- 0.9) 20 Tuberculosis: Number of Cases (2007) 19 43 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 8 43 Asthma: High School Students (2007) 25.8% (+/- 3.2) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 27.1% 10 Infant Mortality: Per 1,000 Live Births (2005) 6.9 25 Low Birthweight: % of Total Births (2006) 6.8% 45 Obesity Rates, % High School Students (2007) 12.8% (+/- 2.7) N/A Obesity Rates, % Children Age 10-17 (2004) 12.7% 34 Pre-Term Labor: % of Live Births (2006) 11.1% 44 Tobacco: Current Smokers High School Students (2007) 21.3% (+/- 3.4) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 75 35 Health Professions Shortage Areas - Mental Health (FY 2008) 30 39 Health Professions Shortage Areas - Dental Care (FY 2008) 60 30 Nursing Shortage Estimates (2010) -2,500 33 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 11,000 39 Potential # of Episodes of Illness During a Severe Pandemic 391,000 40 Potential Financial Loss During a Severe Pandemic, % of GDP 5.38% 40 Potential Financial Loss During a Severe Pandemic, $ amount $2.4 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 61 THE STATE OF YOUR HEALTH: MAINE Public Health Funding Facts Federal Funding for Maine’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $23.53 11 Health Resources and Services Administration (HRSA) FY 2008 $20.60 19 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.60 9 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $150,000 Cancer $2,797,335 Chronic Disease Prevention and Health Promotion $748,119 Diabetes $370,800 Environmental Health $1,552,246 Heart Disease $225,698 HIV/AIDS $1,839,179 Immunization (Sect. 317 and Vaccines for Children Program) $13,544,083 Infectious Diseases $555,058 Injury and Violence Prevention $299,528 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $1,594,791 Preventive Health and Health Services Block Grant $859,434 School Health $231,948 Sexually Transmitted Diseases (STD) $252,843 Tobacco $794,968 Terrorism Preparedness and Emergency Response $4,976,106 Tuberculosis $178,351 Total FY 2008 CDC Dollars (All Categories) $30,970,487 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,023,333 HIV/AIDS $2,437,372 Maternal & Child Health $5,842,473 Primary Health Care $12,917,586 Total FY 2008 HRSA Dollars (All Categories) $27,135,738 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,101,569 Total FY 2008 ASPR HPP Dollars $2,101,569 State Spending State Per Capita Funding for Maine’s Health: $26.82 State Per Capita Funding Ranking:30 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 62 THE STATE OF YOUR HEALTH: MARYLAND State Rank* U.S. Census Bureau 2008 Data Total Population 5,633,597 N/A % Uninsured, All Ages 13.7% 23 % Uninsured, 18 and under 10.5% 19 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 23.0% (+/- 0.8) 25 AIDS: Cumulative Cases Aged 13 & Over (2006) 30,252 9 Alzheimer’s Disease: Estimated Cases (2010) 86,000 22 Asthma: 2005-2007 3 Yr Average (95% CI) 13.1% (+/- 0.8) 20 Cancer: Estimated New Cases (2008) 27,380 19 Chlamydia: Rates per 100,000 Population (2007) 412.2 14 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.8% (+/- 0.4) 23 Human West Nile Virus: New Cases (2008) 14 23 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.7% (+/- 0.8) 21 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.2% (+/- 0.8) 28 Syphilis: Rates per 100,000 Population (2007) 6.1 5 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 17.9% (+/- 0.7) 44 Tuberculosis: Number of Cases (2007) 270 13 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 319 7 Asthma: High School Students (2007) 23.7% (+/- 3.5) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 8.7% 51 Infant Mortality: Per 1,000 Live Births (2005) 7.3 20 Low Birthweight: % of Total Births (2006) 9.4% 9 Obesity Rates, % High School Students (2007) 10.9% (+/- 2.4) N/A Obesity Rates, % Children Age 10-17 (2004) 13.3% 29 Pre-Term Labor: % of Live Births (2006) 13.5% 18 Tobacco: Current Smokers High School Students (2007) 20.4% (+/- 4.6) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 47 42 Health Professions Shortage Areas - Mental Health (FY 2008) 31 37 Health Professions Shortage Areas - Dental Care (FY 2008) 38 38 Nursing Shortage Estimates (2010) -7,000 20 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 41,000 19 Potential # of Episodes of Illness During a Severe Pandemic 1,656,000 19 Potential Financial Loss During a Severe Pandemic, % of GDP 5.09% 50 Potential Financial Loss During a Severe Pandemic, $ amount $12.5 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 63 THE STATE OF YOUR HEALTH: MARYLAND Public Health Funding Facts Federal Funding for Maryland’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $22.92 12 Health Resources and Services Administration (HRSA) FY 2008 $48.17 2 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.30 28 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $5,797,840 Cancer $6,161,595 Chronic Disease Prevention and Health Promotion $3,591,676 Diabetes $692,461 Environmental Health $2,723,601 Heart Disease $325,000 HIV/AIDS $19,099,940 Immunization (Sect. 317 and Vaccines for Children Program) $46,290,154 Infectious Diseases $3,933,124 Injury and Violence Prevention $5,387,689 Nutrition and Physical Activity $0 Occupational Safety and Health $5,984,412 Pandemic Flu $3,329,703 Preventive Health and Health Services Block Grant $2,056,786 School Health $639,726 Sexually Transmitted Diseases (STD) $3,222,706 Tobacco $993,392 Terrorism Preparedness and Emergency Response $17,368,515 Tuberculosis $1,306,115 Total FY 2008 CDC Dollars (All Categories) $129,116,215 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $6,647,386 HIV/AIDS $206,730,531 Maternal & Child Health $20,489,296 Primary Health Care $30,970,966 Total FY 2008 HRSA Dollars (All Categories) $270,622,176 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $7,305,500 Total FY 2008 ASPR HPP Dollars $7,305,500 State Spending State Per Capita Funding for Maryland’s Health: $38.13 State Per Capita Funding Ranking:23 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 64 THE STATE OF YOUR HEALTH: MASSACHUSETTS State Rank* U.S. Census Bureau 2008 Data Total Population 6,497,967 N/A % Uninsured, All Ages 5.4% 51 % Uninsured, 18 and under 3.0% 51 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 21.8% (+/- 0.6) 36 AIDS: Cumulative Cases Aged 13 & Over (2006) 19,181 10 Alzheimer’s Disease: Estimated Cases (2010) 120,000 12 Asthma: 2005-2007 3 Yr Average (95% CI) 14.7% (+/- 0.6) 7 Cancer: Estimated New Cases (2008) 34,470 13 Chlamydia: Rates per 100,000 Population (2007) 250.8 43 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.7% (+/- 0.3) 41 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.8% (+/- 0.6) 34 Obesity: 2005-2007 3 Yr Average (95 % CI) 20.9% (+/- 0.6) 48 Syphilis: Rates per 100,000 Population (2007) 2.4 21 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 17.4% (+/- 0.6) 46 Tuberculosis: Number of Cases (2007) 224 18 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 214 10 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.1% 32 Infant Mortality: Per 1,000 Live Births (2005) 5.2 47 Low Birthweight: % of Total Births (2006) 7.9% 33 Obesity Rates, % High School Students (2007) 11.1% (+/- 1.6) N/A Obesity Rates, % Children Age 10-17 (2004) 13.6% 27 Pre-Term Labor: % of Live Births (2006) 11.3% 42 Tobacco: Current Smokers High School Students (2007) 24.4% (+/- 3.1) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 69 38 Health Professions Shortage Areas - Mental Health (FY 2008) 48 21 Health Professions Shortage Areas - Dental Care (FY 2008) 66 25 Nursing Shortage Estimates (2010) -16,100 9 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 55,000 12 Potential # of Episodes of Illness During a Severe Pandemic 1,895,000 13 Potential Financial Loss During a Severe Pandemic, % of GDP 5.20% 47 Potential Financial Loss During a Severe Pandemic, $ amount $16.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 65 THE STATE OF YOUR HEALTH: MASSACHUSETTS Public Health Funding Facts Federal Funding for Massachusetts’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $20.85 19 Health Resources and Services Administration (HRSA) FY 2008 $36.00 5 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.29 31 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $368,374 Birth Defects and Developmental Disabilities $1,924,618 Cancer $5,814,289 Chronic Disease Prevention and Health Promotion $7,287,645 Diabetes $975,965 Environmental Health $3,300,174 Heart Disease $1,759,341 HIV/AIDS $15,408,293 Immunization (Sect. 317 and Vaccines for Children Program) $59,740,608 Infectious Diseases $1,959,975 Injury and Violence Prevention $3,397,499 Nutrition and Physical Activity $1,058,951 Occupational Safety and Health $2,973,099 Pandemic Flu $2,041,071 Preventive Health and Health Services Block Grant $2,625,825 School Health $1,172,877 Sexually Transmitted Diseases (STD) $1,875,495 Tobacco $1,284,491 Terrorism Preparedness and Emergency Response $19,416,825 Tuberculosis $1,129,386 Total FY 2008 CDC Dollars (All Categories) $135,514,801 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $12,980,319 HIV/AIDS $130,743,929 Maternal & Child Health $26,363,203 Primary Health Care $51,968,593 Total FY 2008 HRSA Dollars (All Categories) $232,216,634 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $8,301,006 Total FY 2008 ASPR HPP Dollars $8,301,006 State Spending State Per Capita Funding for Massachusetts’s Health: $65.92 State Per Capita Funding Ranking:9 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 66 THE STATE OF YOUR HEALTH: MICHIGAN State Rank* U.S. Census Bureau 2008 Data Total Population 10,003,422 N/A % Uninsured, All Ages 11.6% 34 % Uninsured, 18 and under 6.2% 41 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 22.0% (+/- 0.7) 33 AIDS: Cumulative Cases Aged 13 & Over (2006) 14,941 16 Alzheimer’s Disease: Estimated Cases (2010) 180,000 8 Asthma: 2005-2007 3 Yr Average (95% CI) 14.3% (+/- 0.6) 10 Cancer: Estimated New Cases (2008) 51,150 8 Chlamydia: Rates per 100,000 Population (2007) 370.0 20 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.6% (+/- 0.4) 13 Human West Nile Virus: New Cases (2008) 17 19 Hypertension: 2003-2007 3 Yr Average (95% CI) 28.7% (+/- 0.8) 16 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.7% (+/- 0.8) 10 Syphilis: Rates per 100,000 Population (2007) 1.2 32 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 21.8% (+/- 0.8) 17 Tuberculosis: Number of Cases (2007) 226 17 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 113 17 Asthma: High School Students (2007) 23.5% (+/- 2.0) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 21.2% 38 Infant Mortality: Per 1,000 Live Births (2005) 7.9 14 Low Birthweight: % of Total Births (2006) 8.3% 23 Obesity Rates, % High School Students (2007) 12.4% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 14.5% 20 Pre-Term Labor: % of Live Births (2006) 12.5% 28 Tobacco: Current Smokers High School Students (2007) 24.8% (+/- 3.9) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 202 5 Health Professions Shortage Areas - Mental Health (FY 2008) 89 8 Health Professions Shortage Areas - Dental Care (FY 2008) 122 9 Nursing Shortage Estimates (2010) -3,100 28 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 82,000 8 Potential # of Episodes of Illness During a Severe Pandemic 3,003,000 8 Potential Financial Loss During a Severe Pandemic, % of GDP 5.39% 39 Potential Financial Loss During a Severe Pandemic, $ amount $20.3 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 67 THE STATE OF YOUR HEALTH: MICHIGAN Public Health Funding Facts Federal Funding for Michigan’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.76 37 Health Resources and Services Administration (HRSA) FY 2008 $12.14 45 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.26 40 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $648,495 Birth Defects and Developmental Disabilities $2,447,860 Cancer $11,353,660 Chronic Disease Prevention and Health Promotion $6,045,180 Diabetes $1,858,327 Environmental Health $2,660,181 Heart Disease $1,407,809 HIV/AIDS $11,409,113 Immunization (Sect. 317 and Vaccines for Children Program) $80,062,773 Infectious Diseases $2,378,272 Injury and Violence Prevention $1,867,310 Nutrition and Physical Activity $951,678 Occupational Safety and Health $1,631,937 Pandemic Flu $2,183,202 Preventive Health and Health Services Block Grant $3,824,512 School Health $1,018,179 Sexually Transmitted Diseases (STD) $2,688,126 Tobacco $1,374,750 Terrorism Preparedness and Emergency Response $20,767,521 Tuberculosis $1,118,599 Total FY 2008 CDC Dollars (All Categories) $157,697,484 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $8,698,437 HIV/AIDS $29,275,939 Maternal & Child Health $28,563,026 Primary Health Care $46,290,907 Total FY 2008 HRSA Dollars (All Categories) $122,293,351 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $12,734,552 Total FY 2008 ASPR HPP Dollars $12,734,552 State Spending State Per Capita Funding for Michigan’s Health: $21.20 State Per Capita Funding Ranking:35 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 68 THE STATE OF YOUR HEALTH: MINNESOTA State Rank* U.S. Census Bureau 2008 Data Total Population 5,220,393 N/A % Uninsured, All Ages 8.3% 48 % Uninsured, 18 and under 6.4% 40 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 15.7% (+/- 0.9) 51 AIDS: Cumulative Cases Aged 13 & Over (2006) 4,817 30 Alzheimer’s Disease: Estimated Cases (2010) 94,000 20 Asthma: 2005-2007 3 Yr Average (95% CI) 11.3% (+/- 0.8) 43 Cancer: Estimated New Cases (2008) 23,160 23 Chlamydia: Rates per 100,000 Population (2007) 259.6 41 Diabetes: 2005-2007 3 Yr Average (95% CI) 5.7% (+/- 0.5) 48 Human West Nile Virus: New Cases (2008) 21 14 Hypertension: 2003-2007 3 Yr Average (95% CI) 22.6% (+/- 0.9) 49 Obesity: 2005-2007 3 Yr Average (95 % CI) 24.8% (+/- 1.0) 30 Syphilis: Rates per 100,000 Population (2007) 1.1 35 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.3% (+/- 1.0) 40 Tuberculosis: Number of Cases (2007) 238 15 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 28 31 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 19.5% 44 Infant Mortality: Per 1,000 Live Births (2005) 5.1 49 Low Birthweight: % of Total Births (2006) 6.5% 48 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 10.1% 47 Pre-Term Labor: % of Live Births (2006) 10.5% 47 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 118 17 Health Professions Shortage Areas - Mental Health (FY 2008) 46 26 Health Professions Shortage Areas - Dental Care (FY 2008) 67 24 Nursing Shortage Estimates (2010) -4,400 24 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 39,000 20 Potential # of Episodes of Illness During a Severe Pandemic 1,526,000 21 Potential Financial Loss During a Severe Pandemic, % of GDP 5.44% 34 Potential Financial Loss During a Severe Pandemic, $ amount $12.8 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 69 THE STATE OF YOUR HEALTH: MINNESOTA Public Health Funding Facts Federal Funding for Minnesota’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.66 40 Health Resources and Services Administration (HRSA) FY 2008 $11.06 48 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.30 28 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $525,144 Birth Defects and Developmental Disabilities $719,730 Cancer $7,242,628 Chronic Disease Prevention and Health Promotion $4,127,482 Diabetes $971,392 Environmental Health $1,177,005 Heart Disease $1,502,142 HIV/AIDS $4,233,537 Immunization (Sect. 317 and Vaccines for Children Program) $29,779,163 Infectious Diseases $4,302,218 Injury and Violence Prevention $1,355,836 Nutrition and Physical Activity $645,573 Occupational Safety and Health $1,048,290 Pandemic Flu $2,879,084 Preventive Health and Health Services Block Grant $2,438,794 School Health $764,009 Sexually Transmitted Diseases (STD) $989,332 Tobacco $988,675 Terrorism Preparedness and Emergency Response $15,000,469 Tuberculosis $1,003,719 Total FY 2008 CDC Dollars (All Categories) $81,747,496 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $6,016,804 HIV/AIDS $13,256,517 Maternal & Child Health $12,688,554 Primary Health Care $17,460,674 Total FY 2008 HRSA Dollars (All Categories) $57,499,590 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $6,761,826 Total FY 2008 ASPR HPP Dollars $6,761,826 State Spending State Per Capita Funding for Minnesota’s Health: $16.27 State Per Capita Funding Ranking:43 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 70 THE STATE OF YOUR HEALTH: MISSISSIPPI State Rank* U.S. Census Bureau 2008 Data Total Population 2,938,618 N/A % Uninsured, All Ages 18.8% 4 % Uninsured, 18 and under 12.1% 12 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 31.8% (+/- 0.9) 1 AIDS: Cumulative Cases Aged 13 & Over (2006) 6,642 26 Alzheimer’s Disease: Estimated Cases (2010) 53,000 32 Asthma: 2005-2007 3 Yr Average (95% CI) 11.2% (+/- 0.7) 45 Cancer: Estimated New Cases (2008) 13,400 32 Chlamydia: Rates per 100,000 Population (2007) 745.1 2 Diabetes: 2005-2007 3 Yr Average (95% CI) 10.6% (+/- 0.5) 3 Human West Nile Virus: New Cases (2008) 99 3 Hypertension: 2003-2007 3 Yr Average (95% CI) 34.5% (+/- 0.9) 1 Obesity: 2005-2007 3 Yr Average (95 % CI) 31.7% (+/- 1.0) 1 Syphilis: Rates per 100,000 Population (2007) 4.6 12 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 24.2% (+/- 0.9) 6 Tuberculosis: Number of Cases (2007) 137 23 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 56 22 Asthma: High School Students (2007) 17.2% (+/- 2.0) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.9% 24 Infant Mortality: Per 1,000 Live Births (2005) 11.4 2 Low Birthweight: % of Total Births (2006) 12.4% 1 Obesity Rates, % High School Students (2007) 17.9% (+/- 2.5) N/A Obesity Rates, % Children Age 10-17 (2004) 17.8% 8 Pre-Term Labor: % of Live Births (2006) 18.8% 1 Tobacco: Current Smokers High School Students (2007) 25.6% (+/- 3.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 109 22 Health Professions Shortage Areas - Mental Health (FY 2008) 41 33 Health Professions Shortage Areas - Dental Care (FY 2008) 102 14 Nursing Shortage Estimates (2010) -500 43 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 22,000 30 Potential # of Episodes of Illness During a Severe Pandemic 864,000 31 Potential Financial Loss During a Severe Pandemic, % of GDP 5.99% 7 Potential Financial Loss During a Severe Pandemic, $ amount $4.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 71 THE STATE OF YOUR HEALTH: MISSISSIPPI Public Health Funding Facts Federal Funding for Mississippi’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $20.04 21 Health Resources and Services Administration (HRSA) FY 2008 $38.33 3 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.38 17 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $0 Cancer $3,470,471 Chronic Disease Prevention and Health Promotion $144,718 Diabetes $265,062 Environmental Health $812,341 Heart Disease $1,229,246 HIV/AIDS $5,669,760 Immunization (Sect. 317 and Vaccines for Children Program) $33,944,241 Infectious Diseases $716,031 Injury and Violence Prevention $533,290 Nutrition and Physical Activity $35,035 Occupational Safety and Health $0 Pandemic Flu $121,720 Preventive Health and Health Services Block Grant $1,403,587 School Health $661,882 Sexually Transmitted Diseases (STD) $1,040,327 Tobacco $445,576 Terrorism Preparedness and Emergency Response $7,629,747 Tuberculosis $765,440 Total FY 2008 CDC Dollars (All Categories) $58,888,474 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,932,158 HIV/AIDS $18,129,809 Maternal & Child Health $11,016,866 Primary Health Care $40,255,169 Total FY 2008 HRSA Dollars (All Categories) $111,881,930 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $4,027,180 Total FY 2008 ASPR HPP Dollars $4,027,180 State Spending State Per Capita Funding for Mississippi’s Health: $12.64 State Per Capita Funding Ranking:48 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 72 THE STATE OF YOUR HEALTH: MISSOURI State Rank* U.S. Census Bureau 2008 Data Total Population 5,911,605 N/A % Uninsured, All Ages 12.6% 31 % Uninsured, 18 and under 10.4% 21 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 24.7% (+/- 1.1) 18 AIDS: Cumulative Cases Aged 13 & Over (2006) 11,016 21 Alzheimer’s Disease: Estimated Cases (2010) 110,000 16 Asthma: 2005-2007 3 Yr Average (95% CI) 13.4% (+/- 0.9) 17 Cancer: Estimated New Cases (2008) 29,390 16 Chlamydia: Rates per 100,000 Population (2007) 398.9 17 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.7% (+/- 0.5) 25 Human West Nile Virus: New Cases (2008) 19 17 Hypertension: 2003-2007 3 Yr Average (95% CI) 29.1% (+/- 1.1) 15 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.4% (+/- 1.1) 13 Syphilis: Rates per 100,000 Population (2007) 4.1 15 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 23.7% (+/- 1.1) 8 Tuberculosis: Number of Cases (2007) 119 27 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 61 20 Asthma: High School Students (2007) 20.8% (+/- 2.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 23.9% 21 Infant Mortality: Per 1,000 Live Births (2005) 7.5 16 Low Birthweight: % of Total Births (2006) 8.1% 29 Obesity Rates, % High School Students (2007) 12.0% (+/- 3.0) N/A Obesity Rates, % Children Age 10-17 (2004) 15.6% 15 Pre-Term Labor: % of Live Births (2006) 12.8% 24 Tobacco: Current Smokers High School Students (2007) 29.6% (+/- 6.1) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 181 8 Health Professions Shortage Areas - Mental Health (FY 2008) 52 18 Health Professions Shortage Areas - Dental Care (FY 2008) 132 7 Nursing Shortage Estimates (2010) -12,900 10 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 47,000 15 Potential # of Episodes of Illness During a Severe Pandemic 1,717,000 18 Potential Financial Loss During a Severe Pandemic, % of GDP 5.74% 14 Potential Financial Loss During a Severe Pandemic, $ amount $12.4 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 73 THE STATE OF YOUR HEALTH: MISSOURI Public Health Funding Facts Federal Funding for Missouri’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.14 41 Health Resources and Services Administration (HRSA) FY 2008 $17.32 27 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.29 31 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $391,873 Birth Defects and Developmental Disabilities $1,269,375 Cancer $5,689,240 Chronic Disease Prevention and Health Promotion $2,079,021 Diabetes $471,532 Environmental Health $1,966,339 Heart Disease $1,225,000 HIV/AIDS $6,084,678 Immunization (Sect. 317 and Vaccines for Children Program) $46,695,107 Infectious Diseases $1,288,234 Injury and Violence Prevention $1,137,008 Nutrition and Physical Activity $356,573 Occupational Safety and Health $35,614 Pandemic Flu $216,676 Preventive Health and Health Services Block Grant $2,550,206 School Health $222,650 Sexually Transmitted Diseases (STD) $2,483,080 Tobacco $953,317 Terrorism Preparedness and Emergency Response $13,753,474 Tuberculosis $565,709 Total FY 2008 CDC Dollars (All Categories) $89,491,706 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,281,346 HIV/AIDS $28,336,772 Maternal & Child Health $18,171,016 Primary Health Care $42,507,359 Total FY 2008 HRSA Dollars (All Categories) $101,802,743 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $7,580,577 Total FY 2008 ASPR HPP Dollars $7,580,577 State Spending State Per Capita Funding for Missouri’s Health: $8.81 State Per Capita Funding Ranking:50 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 74 THE STATE OF YOUR HEALTH: MONTANA State Rank* U.S. Census Bureau 2008 Data Total Population 967,440 N/A % Uninsured, All Ages 15.6% 18 % Uninsured, 18 and under 12.6% 9 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 20.4% (+/- 0.9) 41 AIDS: Cumulative Cases Aged 13 & Over (2006) 373 48 Alzheimer’s Disease: Estimated Cases (2010) 21,000 44 Asthma: 2005-2007 3 Yr Average (95% CI) 12.7% (+/- 0.7) 28 Cancer: Estimated New Cases (2008) 5,090 44 Chlamydia: Rates per 100,000 Population (2007) 290.9 36 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.2% (+/- 0.4) 47 Human West Nile Virus: New Cases (2008) 5 34 Hypertension: 2003-2007 3 Yr Average (95% CI) 24.5% (+/- 0.9) 45 Obesity: 2005-2007 3 Yr Average (95 % CI) 21.7% (+/- 0.8) 45 Syphilis: Rates per 100,000 Population (2007) 0.8 41 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.2% (+/- 0.8) 33 Tuberculosis: Number of Cases (2007) 11 46 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 3 48 Asthma: High School Students (2007) 20.9% (+/- 1.7) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 34.7% 2 Infant Mortality: Per 1,000 Live Births (2005) 7.0 24 Low Birthweight: % of Total Births (2006) 7.3% 34 Obesity Rates, % High School Students (2007) 10.1% (+/- 1.1) N/A Obesity Rates, % Children Age 10-17 (2004) 11.1% 44 Pre-Term Labor: % of Live Births (2006) 11.9% 35 Tobacco: Current Smokers High School Students (2007) 30.0% (+/- 2.9) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 92 27 Health Professions Shortage Areas - Mental Health (FY 2008) 50 20 Health Professions Shortage Areas - Dental Care (FY 2008) 57 32 Nursing Shortage Estimates (2010)= -500 43 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 7,000 44 Potential # of Episodes of Illness During a Severe Pandemic 277,000 44 Potential Financial Loss During a Severe Pandemic, % of GDP 5.86% 12 Potential Financial Loss During a Severe Pandemic, $ amount $1.8 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 75 THE STATE OF YOUR HEALTH: MONTANA Public Health Funding Facts Federal Funding for Montana’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $24.33 10 Health Resources and Services Administration (HRSA) FY 2008 $36.38 4 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.72 7 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $871,547 Cancer $3,009,966 Chronic Disease Prevention and Health Promotion $0 Diabetes $697,655 Environmental Health $0 Heart Disease $1,098,195 HIV/AIDS $1,743,227 Immunization (Sect. 317 and Vaccines for Children Program) $7,334,264 Infectious Diseases $639,097 Injury and Violence Prevention $264,217 Nutrition and Physical Activity $823,955 Occupational Safety and Health $107,000 Pandemic Flu $84,367 Preventive Health and Health Services Block Grant $636,129 School Health $208,000 Sexually Transmitted Diseases (STD) $253,684 Tobacco $792,875 Terrorism Preparedness and Emergency Response $4,855,493 Tuberculosis $121,789 Total FY 2008 CDC Dollars (All Categories) $23,541,460 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $3,194,210 HIV/AIDS $1,439,188 Maternal & Child Health $3,777,038 Primary Health Care $17,558,820 Total FY 2008 HRSA Dollars (All Categories) $34,851,298 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,644,766 Total FY 2008 ASPR HPP Dollars $1,644,766 State Spending State Per Capita Funding for Montana’s Health: $25.35 State Per Capita Funding Ranking:31 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 76 THE STATE OF YOUR HEALTH: NEBRASKA State Rank* U.S. Census Bureau 2008 Data Total Population 1,783,432 N/A % Uninsured, All Ages 13.2% 27 % Uninsured, 18 and under 10.0% 23 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 22.3% (+/- 0.8) 32 AIDS: Cumulative Cases Aged 13 & Over (2006) 1,479 42 Alzheimer’s Disease: Estimated Cases (2010) 37,000 35 Asthma: 2005-2007 3 Yr Average (95% CI) 11.1% (+/- 0.7) 46 Cancer: Estimated New Cases (2008) 8,710 36 Chlamydia: Rates per 100,000 Population (2007) 290.2 37 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.3% (+/- 0.4) 32 Human West Nile Virus: New Cases (2008) 49 6 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.5% (+/- 0.8) 37 Obesity: 2005-2007 3 Yr Average (95 % CI) 26.5% (+/- 0.9) 18 Syphilis: Rates per 100,000 Population (2007) 0.2 49 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.9% (+/- 0.9) 29 Tuberculosis: Number of Cases (2007) 25 41 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 11 40 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 17.1% 47 Infant Mortality: Per 1,000 Live Births (2005) 5.6 43 Low Birthweight: % of Total Births (2006) 7.1% 36 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 11.9% 41 Pre-Term Labor: % of Live Births (2006) 12.5% 28 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 75 35 Health Professions Shortage Areas - Mental Health (FY 2008) 19 44 Health Professions Shortage Areas - Dental Care (FY 2008) 32 41 Nursing Shortage Estimates (2010) -2,400 34 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 14,000 34 Potential # of Episodes of Illness During a Severe Pandemic 520,000 38 Potential Financial Loss During a Severe Pandemic, % of GDP 6.22% 5 Potential Financial Loss During a Severe Pandemic, $ amount $4.4 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 77 THE STATE OF YOUR HEALTH: NEBRASKA Public Health Funding Facts Federal Funding for Nebraska’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $20.54 20 Health Resources and Services Administration (HRSA) FY 2008 $15.39 36 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.49 13 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $149,529 Cancer $5,026,154 Chronic Disease Prevention and Health Promotion $810,871 Diabetes $314,631 Environmental Health $0 Heart Disease $467,373 HIV/AIDS $1,445,793 Immunization (Sect. 317 and Vaccines for Children Program) $15,645,208 Infectious Diseases $1,015,191 Injury and Violence Prevention $358,751 Nutrition and Physical Activity $937,478 Occupational Safety and Health $20,486 Pandemic Flu $1,074,095 Preventive Health and Health Services Block Grant $1,597,263 School Health $190,000 Sexually Transmitted Diseases (STD) $451,318 Tobacco $1,022,755 Terrorism Preparedness and Emergency Response $5,848,300 Tuberculosis $210,957 Total FY 2008 CDC Dollars (All Categories) $36,639,529 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $2,893,709 HIV/AIDS $3,067,519 Maternal & Child Health $7,886,799 Primary Health Care $7,794,411 Total FY 2008 HRSA Dollars (All Categories) $27,316,904 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,642,978 Total FY 2008 ASPR HPP Dollars $2,642,978 State Spending State Per Capita Funding for Nebraska’s Health: $36.67 State Per Capita Funding Ranking:24 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 78 THE STATE OF YOUR HEALTH: NEVADA State Rank* U.S. Census Bureau 2008 Data Total Population 2,600,167 N/A % Uninsured, All Ages 17.2% 11 % Uninsured, 18 and under 14.3% 4 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 26.1% (+/- 1.3) 11 AIDS: Cumulative Cases Aged 13 & Over (2006) 5,733 28 Alzheimer’s Disease: Estimated Cases (2010) 29,000 38 Asthma: 2005-2007 3 Yr Average (95% CI) 12.7% (+/- 1.0) 26 Cancer: Estimated New Cases (2008) 11,370 34 Chlamydia: Rates per 100,000 Population (2007) 381.2 19 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.6% (+/- 0.7) 27 Human West Nile Virus: New Cases (2008) 16 21 Hypertension: 2003-2007 3 Yr Average (95% CI) 26.0% (+/- 1.2) 31 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.6% (+/- 1.3) 35 Syphilis: Rates per 100,000 Population (2007) 4.4 13 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 22.2% (+/- 1.2) 14 Tuberculosis: Number of Cases (2007) 102 31 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 29 30 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 36.9% 1 Infant Mortality: Per 1,000 Live Births (2005) 5.8 40 Low Birthweight: % of Total Births (2006) 8.3% 23 Obesity Rates, % High School Students (2007) 11.0% (+/- 2.3) N/A Obesity Rates, % Children Age 10-17 (2004) 12.4% 36 Pre-Term Labor: % of Live Births (2006) 14.4% 8 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 55 41 Health Professions Shortage Areas - Mental Health (FY 2008) 18 46 Health Professions Shortage Areas - Dental Care (FY 2008) 20 45 Nursing Shortage Estimates (2010) -4,100 25 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 13,000 36 Potential # of Episodes of Illness During a Severe Pandemic 720,000 35 Potential Financial Loss During a Severe Pandemic, % of GDP 8.08% 1 Potential Financial Loss During a Severe Pandemic, $ amount $9.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 79 THE STATE OF YOUR HEALTH: NEVADA Public Health Funding Facts Federal Funding for Nevada’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $19.67 22 Health Resources and Services Administration (HRSA) FY 2008 $13.98 41 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.37 20 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $462,830 Cancer $3,641,755 Chronic Disease Prevention and Health Promotion $355,000 Diabetes $348,218 Environmental Health $516,644 Heart Disease $0 HIV/AIDS $3,612,161 Immunization (Sect. 317 and Vaccines for Children Program) $30,635,333 Infectious Diseases $801,003 Injury and Violence Prevention $380,548 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $34,026 Preventive Health and Health Services Block Grant $382,108 School Health $255,699 Sexually Transmitted Diseases (STD) $748,234 Tobacco $707,071 Terrorism Preparedness and Emergency Response $7,721,260 Tuberculosis $541,270 Total FY 2008 CDC Dollars (All Categories) $51,143,160 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,992,574 HIV/AIDS $14,752,655 Maternal & Child Health $3,330,409 Primary Health Care $9,569,664 Total FY 2008 HRSA Dollars (All Categories) $35,860,118 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $3,524,243 Total FY 2008 ASPR HPP Dollars $3,524,243 State Spending State Per Capita Funding for Nevada’s Health: $3.37 State Per Capita Funding Ranking:51 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 80 THE STATE OF YOUR HEALTH: NEW HAMPSHIRE State Rank* U.S. Census Bureau 2008 Data Total Population 1,315,809 N/A % Uninsured, All Ages 10.5% 40 % Uninsured, 18 and under 6.5% 39 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 20.1% (+/- 0.7) 43 AIDS: Cumulative Cases Aged 13 & Over (2006) 1,074 44 Alzheimer’s Disease: Estimated Cases (2010) 22,000 43 Asthma: 2005-2007 3 Yr Average (95% CI) 14.9% (+/- 0.7) 4 Cancer: Estimated New Cases (2008) 7,030 40 Chlamydia: Rates per 100,000 Population (2007) 156.3 51 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.0% (+/- 0.4) 37 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 24.9% (+/- 0.8) 43 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.6% (+/- 0.8) 36 Syphilis: Rates per 100,000 Population (2007) 2.3 24 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.5% (+/- 0.8) 31 Tuberculosis: Number of Cases (2007) 11 46 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 10 42 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 9.4% 50 Infant Mortality: Per 1,000 Live Births (2005) 5.3 44 Low Birthweight: % of Total Births (2006) 6.9% 39 Obesity Rates, % High School Students (2007) 11.7% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 12.9% 33 Pre-Term Labor: % of Live Births (2006) 10.4% 48 Tobacco: Current Smokers High School Students (2007) 26.6% (+/- 3.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 25 47 Health Professions Shortage Areas - Mental Health (FY 2008) 16 48 Health Professions Shortage Areas - Dental Care (FY 2008) 20 45 Nursing Shortage Estimates (2010) -3,300 27 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 10,000 41 Potential # of Episodes of Illness During a Severe Pandemic 389,000 41 Potential Financial Loss During a Severe Pandemic, % of GDP 5.30% 44 Potential Financial Loss During a Severe Pandemic, $ amount $2.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 81 THE STATE OF YOUR HEALTH: NEW HAMPSHIRE Public Health Funding Facts Federal Funding for New Hampshire’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $21.07 17 Health Resources and Services Administration (HRSA) FY 2008 $15.05 38 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.59 11 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $291,357 Birth Defects and Developmental Disabilities $628,140 Cancer $2,443,537 Chronic Disease Prevention and Health Promotion $0 Diabetes $391,268 Environmental Health $1,348,002 Heart Disease $77,564 HIV/AIDS $1,687,326 Immunization (Sect. 317 and Vaccines for Children Program) $9,157,388 Infectious Diseases $690,080 Injury and Violence Prevention $759,452 Nutrition and Physical Activity $380,847 Occupational Safety and Health $446,325 Pandemic Flu $927,091 Preventive Health and Health Services Block Grant $1,636,232 School Health $196,777 Sexually Transmitted Diseases (STD) $238,183 Tobacco $858,560 Terrorism Preparedness and Emergency Response $5,302,054 Tuberculosis $259,122 Total FY 2008 CDC Dollars (All Categories) $27,719,305 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,379,705 HIV/AIDS $2,322,509 Maternal & Child Health $4,104,838 Primary Health Care $8,457,255 Total FY 2008 HRSA Dollars (All Categories) $19,801,741 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,093,475 Total FY 2008 ASPR HPP Dollars $2,093,475 State Spending State Per Capita Funding for New Hampshire’s Health: $23.03 State Per Capita Funding Ranking:34 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 82 THE STATE OF YOUR HEALTH: NEW JERSEY State Rank* U.S. Census Bureau 2008 Data Total Population 8,682,661 N/A % Uninsured, All Ages 15.8% 17 % Uninsured, 18 and under 12.9% 8 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 27.4% (+/- 0.7) 10 AIDS: Cumulative Cases Aged 13 & Over (2006) 48,750 5 Alzheimer’s Disease: Estimated Cases (2010) 150,000 10 Asthma: 2005-2007 3 Yr Average (95% CI) 12.2% (+/- 0.6) 37 Cancer: Estimated New Cases (2008) 45,900 9 Chlamydia: Rates per 100,000 Population (2007) 246.8 44 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.1% (+/- 0.4) 19 Human West Nile Virus: New Cases (2008) 7 31 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.2% (+/- 0.7) 25 Obesity: 2005-2007 3 Yr Average (95 % CI) 22.9% (+/- 0.7) 42 Syphilis: Rates per 100,000 Population (2007) 2.6 20 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 17.7% (+/- 0.7) 45 Tuberculosis: Number of Cases (2007) 467 7 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 778 3 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 19.5% 44 Infant Mortality: Per 1,000 Live Births (2005) 5.2 47 Low Birthweight: % of Total Births (2006) 8.6% 19 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 13.7% 26 Pre-Term Labor: % of Live Births (2006) 12.9% 23 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 35 45 Health Professions Shortage Areas - Mental Health (FY 2008) 28 40 Health Professions Shortage Areas - Dental Care (FY 2008) 30 42 Nursing Shortage Estimates (2010) -19,600 6 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 71,000 9 Potential # of Episodes of Illness During a Severe Pandemic 2,585,000 10 Potential Financial Loss During a Severe Pandemic, % of GDP 5.42% 35 Potential Financial Loss During a Severe Pandemic, $ amount $23.4 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 83 THE STATE OF YOUR HEALTH: NEW JERSEY Public Health Funding Facts Federal Funding for New Jersey’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.75 38 Health Resources and Services Administration (HRSA) FY 2008 $17.06 29 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.27 37 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $605,070 Birth Defects and Developmental Disabilities $6,033,107 Cancer $4,271,542 Chronic Disease Prevention and Health Promotion $133,519 Diabetes $839,126 Environmental Health $2,691,719 Heart Disease $332,114 HIV/AIDS $24,658,797 Immunization (Sect. 317 and Vaccines for Children Program) $62,868,856 Infectious Diseases $1,069,147 Injury and Violence Prevention $1,351,378 Nutrition and Physical Activity $815,092 Occupational Safety and Health $373,315 Pandemic Flu $147,372 Preventive Health and Health Services Block Grant $2,803,799 School Health $949,689 Sexually Transmitted Diseases (STD) $2,818,525 Tobacco $1,050,687 Terrorism Preparedness and Emergency Response $19,261,216 Tuberculosis $3,684,681 Total FY 2008 CDC Dollars (All Categories) $136,758,751 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $8,042,050 HIV/AIDS $81,551,938 Maternal & Child Health $15,046,892 Primary Health Care $34,874,978 Total FY 2008 HRSA Dollars (All Categories) $148,152,925 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $11,072,985 Total FY 2008 ASPR HPP Dollars $11,072,985 State Spending State Per Capita Funding for New Jersey’s Health: $34.96 State Per Capita Funding Ranking:25 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 84 THE STATE OF YOUR HEALTH: NEW MEXICO State Rank* U.S. Census Bureau 2008 Data Total Population 1,984,356 N/A % Uninsured, All Ages 22.5% 2 % Uninsured, 18 and under 15.5% 3 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 22.5% (+/- 0.8) 29 AIDS: Cumulative Cases Aged 13 & Over (2006) 2,603 37 Alzheimer’s Disease: Estimated Cases (2010) 31,000 37 Asthma: 2005-2007 3 Yr Average (95% CI) 14.1% (+/- 0.7) 11 Cancer: Estimated New Cases (2008) 8,260 37 Chlamydia: Rates per 100,000 Population (2007) 484.0 6 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.5% (+/- 0.5) 29 Human West Nile Virus: New Cases (2008) 9 26 Hypertension: 2003-2007 3 Yr Average (95% CI) 24.0% (+/- 0.8) 47 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.3% (+/- 0.9) 39 Syphilis: Rates per 100,000 Population (2007) 2.4 21 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.8% (+/- 0.8) 19 Tuberculosis: Number of Cases (2007) 51 36 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 7 44 Asthma: High School Students (2007) 24.9% (+/- 3.0) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 24.0% 19 Infant Mortality: Per 1,000 Live Births (2005) 6.1 35 Low Birthweight: % of Total Births (2006) 8.9% 14 Obesity Rates, % High School Students (2007) 10.9% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 16.8% 10 Pre-Term Labor: % of Live Births (2006) 14.1% 9 Tobacco: Current Smokers High School Students (2007) 30.2% (+/- 4.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 91 28 Health Professions Shortage Areas - Mental Health (FY 2008) 43 30 Health Professions Shortage Areas - Dental Care (FY 2008) 63 28 Nursing Shortage Estimates (2010) -3,100 28 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 13,000 38 Potential # of Episodes of Illness During a Severe Pandemic 571,000 36 Potential Financial Loss During a Severe Pandemic, % of GDP 5.42% 35 Potential Financial Loss During a Severe Pandemic, $ amount $3.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 85 THE STATE OF YOUR HEALTH: NEW MEXICO Public Health Funding Facts Federal Funding for New Mexico’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $30.94 5 Health Resources and Services Administration (HRSA) FY 2008 $33.44 7 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.46 15 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $22,934 Birth Defects and Developmental Disabilities $147,303 Cancer $3,581,930 Chronic Disease Prevention and Health Promotion $2,440,299 Diabetes $476,056 Environmental Health $1,519,372 Heart Disease $44,000 HIV/AIDS $2,665,881 Immunization (Sect. 317 and Vaccines for Children Program) $37,066,971 Infectious Diseases $1,484,413 Injury and Violence Prevention $547,132 Nutrition and Physical Activity $0 Occupational Safety and Health $101,000 Pandemic Flu $839,371 Preventive Health and Health Services Block Grant $1,491,019 School Health $238,800 Sexually Transmitted Diseases (STD) $635,659 Tobacco $940,567 Terrorism Preparedness and Emergency Response $6,797,290 Tuberculosis $363,644 Total FY 2008 CDC Dollars (All Categories) $61,403,641 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $2,576,643 HIV/AIDS $5,881,256 Maternal & Child Health $8,634,426 Primary Health Care $36,787,193 Total FY 2008 HRSA Dollars (All Categories) $65,883,562 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,868,709 Total FY 2008 ASPR HPP Dollars $2,868,709 State Spending State Per Capita Funding for New Mexico’s Health: $62.58 State Per Capita Funding Ranking:11 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 86 THE STATE OF YOUR HEALTH: NEW YORK State Rank* U.S. Census Bureau 2008 Data Total Population 19,490,297 N/A % Uninsured, All Ages 13.2% 27 % Uninsured, 18 and under 8.9% 27 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 25.8% (+/- 0.8) 12 AIDS: Cumulative Cases Aged 13 & Over (2006) 174,908 1 Alzheimer’s Disease: Estimated Cases (2010) 320,000 4 Asthma: 2005-2007 3 Yr Average (95% CI) 13.6% (+/- 0.7) 14 Cancer: Estimated New Cases (2008) 97,130 3 Chlamydia: Rates per 100,000 Population (2007) 418.1 12 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.0% (+/- 0.5) 21 Human West Nile Virus: New Cases (2008) 44 7 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.0% (+/- 0.8) 26 Obesity: 2005-2007 3 Yr Average (95 % CI) 23.5% (+/- 0.8) 37 Syphilis: Rates per 100,000 Population (2007) 5.5 8 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.2% (+/- 0.8) 34 Tuberculosis: Number of Cases (2007) 1175 3 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 2354 1 Asthma: High School Students (2007) 23.9% (+/- 1.8) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.2% 31 Infant Mortality: Per 1,000 Live Births (2005) 5.8 40 Low Birthweight: % of Total Births (2006) 8.3% 23 Obesity Rates, % High School Students (2007) 10.9% (+/- 1.1) N/A Obesity Rates, % Children Age 10-17 (2004) 15.3% 18 Pre-Term Labor: % of Live Births (2006) 12.4% 30 Tobacco: Current Smokers High School Students (2007) 17.7% (+/- 2.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 175 9 Health Professions Shortage Areas - Mental Health (FY 2008) 126 4 Health Professions Shortage Areas - Dental Care (FY 2008) 104 11 Nursing Shortage Estimates (2010) -21,500 4 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 157,000 2 Potential # of Episodes of Illness During a Severe Pandemic 5,706,000 3 Potential Financial Loss During a Severe Pandemic, % of GDP 5.20% 47 Potential Financial Loss During a Severe Pandemic, $ amount $49.8 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 87 THE STATE OF YOUR HEALTH: NEW YORK Public Health Funding Facts Federal Funding for New York’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $21.39 14 Health Resources and Services Administration (HRSA) FY 2008 $28.40 9 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $0.72 50 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $915,283 Birth Defects and Developmental Disabilities $6,313,803 Cancer $11,537,388 Chronic Disease Prevention and Health Promotion $14,033,684 Diabetes $948,477 Environmental Health $6,108,572 Heart Disease $1,476,889 HIV/AIDS $85,163,409 Immunization (Sect. 317 and Vaccines for Children Program) $195,627,003 Infectious Diseases $9,130,929 Injury and Violence Prevention $5,987,693 Nutrition and Physical Activity $1,690,118 Occupational Safety and Health $1,673,487 Pandemic Flu $2,383,993 Preventive Health and Health Services Block Grant $6,676,150 School Health $1,395,000 Sexually Transmitted Diseases (STD) $8,700,153 Tobacco $1,544,471 Terrorism Preparedness and Emergency Response $45,986,506 Tuberculosis $9,518,481 Total FY 2008 CDC Dollars (All Categories) $416,872,239 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $23,732,980 HIV/AIDS $340,160,953 Maternal & Child Health $54,889,739 Primary Health Care $106,041,266 Total FY 2008 HRSA Dollars (All Categories) $548,149,085 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $13,941,707 Total FY 2008 ASPR HPP Dollars $13,941,707 State Spending State Per Capita Funding for New York’s Health: $68.84 State Per Capita Funding Ranking:7 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 88 THE STATE OF YOUR HEALTH: NORTH CAROLINA State Rank* U.S. Census Bureau 2008 Data Total Population 9,222,414 N/A % Uninsured, All Ages 16.4% 13 % Uninsured, 18 and under 12.1% 12 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 24.6% (+/- 0.6) 20 AIDS: Cumulative Cases Aged 13 & Over (2006) 15,954 14 Alzheimer’s Disease: Estimated Cases (2010) 170,000 9 Asthma: 2005-2007 3 Yr Average (95% CI) 11.1% (+/- 0.5) 47 Cancer: Estimated New Cases (2008) 40,420 10 Chlamydia: Rates per 100,000 Population (2007) 345.6 26 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.9% (+/- 0.3) 10 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 29.8% (+/- 0.7) 10 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.1% (+/- 0.6) 16 Syphilis: Rates per 100,000 Population (2007) 3.6 16 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 22.5% (+/- 0.6) 13 Tuberculosis: Number of Cases (2007) 345 8 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 118 16 Asthma: High School Students (2007) 20.3% (+/- 2.4) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.7% 28 Infant Mortality: Per 1,000 Live Births (2005) 8.8 8 Low Birthweight: % of Total Births (2006) 9.1% 12 Obesity Rates, % High School Students (2007) 12.8% (+/- 2.4) N/A Obesity Rates, % Children Age 10-17 (2004) 19.3% 5 Pre-Term Labor: % of Live Births (2006) 13.6% 17 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 116 19 Health Professions Shortage Areas - Mental Health (FY 2008) 53 16 Health Professions Shortage Areas - Dental Care (FY 2008) 103 12 Nursing Shortage Estimates (2010) -8,100 19 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 62,000 10 Potential # of Episodes of Illness During a Severe Pandemic 2,556,000 11 Potential Financial Loss During a Severe Pandemic, % of GDP 5.48% 30 Potential Financial Loss During a Severe Pandemic, $ amount $19.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 89 THE STATE OF YOUR HEALTH: NORTH CAROLINA Public Health Funding Facts Federal Funding for North Carolina’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $19.00 25 Health Resources and Services Administration (HRSA) FY 2008 $15.25 37 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.24 44 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $175,136 Birth Defects and Developmental Disabilities $3,110,212 Cancer $7,245,926 Chronic Disease Prevention and Health Promotion $3,481,429 Diabetes $1,999,046 Environmental Health $1,081,430 Heart Disease $2,115,000 HIV/AIDS $10,591,240 Immunization (Sect. 317 and Vaccines for Children Program) $109,569,898 Infectious Diseases $1,162,138 Injury and Violence Prevention $3,143,141 Nutrition and Physical Activity $1,404,275 Occupational Safety and Health $1,243,287 Pandemic Flu $105,802 Preventive Health and Health Services Block Grant $2,944,884 School Health $1,076,359 Sexually Transmitted Diseases (STD) $2,419,315 Tobacco $1,378,253 Terrorism Preparedness and Emergency Response $18,866,091 Tuberculosis $1,830,037 Total FY 2008 CDC Dollars (All Categories) $175,248,392 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $10,789,796 HIV/AIDS $43,122,696 Maternal & Child Health $24,932,000 Primary Health Care $51,753,619 Total FY 2008 HRSA Dollars (All Categories) $138,140,389 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $11,232,884 Total FY 2008 ASPR HPP Dollars $11,232,884 State Spending State Per Capita Funding for North Carolina’s Health: $16.31 State Per Capita Funding Ranking:42 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 90 THE STATE OF YOUR HEALTH: NORTH DAKOTA State Rank* U.S. Census Bureau 2008 Data Total Population 641,481 N/A % Uninsured, All Ages 10.0% 42 % Uninsured, 18 and under 7.9% 32 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 22.5% (+/- 0.9) 28 AIDS: Cumulative Cases Aged 13 & Over (2006) 144 51 Alzheimer’s Disease: Estimated Cases (2010) 18,000 46 Asthma: 2005-2007 3 Yr Average (95% CI) 10.9% (+/- 0.8) 48 Cancer: Estimated New Cases (2008) 3,090 48 Chlamydia: Rates per 100,000 Population (2007) 281.3 39 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.5% (+/- 0.5) 43 Human West Nile Virus: New Cases (2008) 43 8 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.1% (+/- 0.9) 42 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.9% (+/- 1.0) 22 Syphilis: Rates per 100,000 Population (2007) 0.2 49 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.2% (+/- 0.9) 26 Tuberculosis: Number of Cases (2007) 7 49 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 1 51 Asthma: High School Students (2007) 19.4% (+/- 2.0) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.8% 27 Infant Mortality: Per 1,000 Live Births (2005) 6.0 37 Low Birthweight: % of Total Births (2006) 6.7% 47 Obesity Rates, % High School Students (2007) 10.0% (+/- 1.9) N/A Obesity Rates, % Children Age 10-17 (2004) 12.1% 39 Pre-Term Labor: % of Live Births (2006) 12.1% 32 Tobacco: Current Smokers High School Students (2007) 27.4% (+/- 3.2) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 76 34 Health Professions Shortage Areas - Mental Health (FY 2008) 42 31 Health Professions Shortage Areas - Dental Care (FY 2008) 27 43 Nursing Shortage Estimates (2010) -900 40 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 6,000 44 Potential # of Episodes of Illness During a Severe Pandemic 186,000 48 Potential Financial Loss During a Severe Pandemic, % of GDP 5.71% 16 Potential Financial Loss During a Severe Pandemic, $ amount $1.4 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 91 THE STATE OF YOUR HEALTH: NORTH DAKOTA Public Health Funding Facts Federal Funding for North Dakota’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $27.45 7 Health Resources and Services Administration (HRSA) FY 2008 $23.58 16 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.99 3 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $50,000 Birth Defects and Developmental Disabilities $350,000 Cancer $2,014,581 Chronic Disease Prevention and Health Promotion $234,408 Diabetes $273,138 Environmental Health $0 Heart Disease $350,000 HIV/AIDS $645,311 Immunization (Sect. 317 and Vaccines for Children Program) $5,466,442 Infectious Diseases $614,873 Injury and Violence Prevention $300,651 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $296,034 Preventive Health and Health Services Block Grant $247,175 School Health $545,000 Sexually Transmitted Diseases (STD) $264,085 Tobacco $952,598 Terrorism Preparedness and Emergency Response $4,837,509 Tuberculosis $165,982 Total FY 2008 CDC Dollars (All Categories) $17,607,787 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $2,194,797 HIV/AIDS $343,526 Maternal & Child Health $3,232,934 Primary Health Care $4,373,681 Total FY 2008 HRSA Dollars (All Categories) $15,087,012 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,270,585 Total FY 2008 ASPR HPP Dollars $1,270,585 State Spending State Per Capita Funding for North Dakota’s Health: $16.92 State Per Capita Funding Ranking:41 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 92 THE STATE OF YOUR HEALTH: OHIO State Rank* U.S. Census Bureau 2008 Data Total Population 11,485,910 N/A % Uninsured, All Ages 11.7% 33 % Uninsured, 18 and under 8.6% 29 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 24.8% (+/- 1.0) 17 AIDS: Cumulative Cases Aged 13 & Over (2006) 14,957 15 Alzheimer’s Disease: Estimated Cases (2010) 230,000 6 Asthma: 2005-2007 3 Yr Average (95% CI) 12.7% (+/- 0.8) 27 Cancer: Estimated New Cases (2008) 56,840 7 Chlamydia: Rates per 100,000 Population (2007) 413.3 13 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.0% (+/- 0.5) 21 Human West Nile Virus: New Cases (2008) 20 16 Hypertension: 2003-2007 3 Yr Average (95% CI) 28.2% (+/- 0.9) 17 Obesity: 2005-2007 3 Yr Average (95 % CI) 26.9% (+/- 1.1) 17 Syphilis: Rates per 100,000 Population (2007) 1.7 29 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 22.6% (+/- 1.0) 12 Tuberculosis: Number of Cases (2007) 252 14 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 138 14 Asthma: High School Students (2007) 21.3% (+/- 1.7) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.3% 30 Infant Mortality: Per 1,000 Live Births (2005) 8.3 9 Low Birthweight: % of Total Births (2006) 8.8% 17 Obesity Rates, % High School Students (2007) 12.4% (+/- 2.2) N/A Obesity Rates, % Children Age 10-17 (2004) 14.2% 22 Pre-Term Labor: % of Live Births (2006) 13.3% 19 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 116 19 Health Professions Shortage Areas - Mental Health (FY 2008) 55 15 Health Professions Shortage Areas - Dental Care (FY 2008) 91 16 Nursing Shortage Estimates (2010) -12,100 12 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 96,000 7 Potential # of Episodes of Illness During a Severe Pandemic 3,396,000 7 Potential Financial Loss During a Severe Pandemic, % of GDP 5.54% 26 Potential Financial Loss During a Severe Pandemic, $ amount $24.4 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 93 THE STATE OF YOUR HEALTH: OHIO Public Health Funding Facts Federal Funding for Ohio’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $12.76 49 Health Resources and Services Administration (HRSA) FY 2008 $11.10 47 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.26 40 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $519,109 Birth Defects and Developmental Disabilities $1,120,847 Cancer $5,745,694 Chronic Disease Prevention and Health Promotion $2,769,999 Diabetes $935,153 Environmental Health $1,770,052 Heart Disease $1,166,522 HIV/AIDS $7,716,535 Immunization (Sect. 317 and Vaccines for Children Program) $81,979,127 Infectious Diseases $5,289,121 Injury and Violence Prevention $3,122,255 Nutrition and Physical Activity $0 Occupational Safety and Health $791,068 Pandemic Flu $182,166 Preventive Health and Health Services Block Grant $4,194,561 School Health $850,954 Sexually Transmitted Diseases (STD) $3,525,490 Tobacco $1,126,657 Terrorism Preparedness and Emergency Response $22,321,759 Tuberculosis $1,123,551 Total FY 2008 CDC Dollars (All Categories) $146,519,336 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $6,235,019 HIV/AIDS $31,968,930 Maternal & Child Health $28,568,314 Primary Health Care $47,287,193 Total FY 2008 HRSA Dollars (All Categories) $127,240,045 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $14,409,789 Total FY 2008 ASPR HPP Dollars $14,409,789 State Spending State Per Capita Funding for Ohio’s Health: $15.05 State Per Capita Funding Ranking:46 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 94 THE STATE OF YOUR HEALTH: OKLAHOMA State Rank* U.S. Census Bureau 2008 Data Total Population 3,642,361 N/A % Uninsured, All Ages 17.8% 9 % Uninsured, 18 and under 12.6% 9 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 30.0% (+/- 0.8) 5 AIDS: Cumulative Cases Aged 13 & Over (2006) 4,836 29 Alzheimer’s Disease: Estimated Cases (2010) 74,000 27 Asthma: 2005-2007 3 Yr Average (95% CI) 13.6% (+/- 0.6) 15 Cancer: Estimated New Cases (2008) 17,860 29 Chlamydia: Rates per 100,000 Population (2007) 350.0 25 Diabetes: 2005-2007 3 Yr Average (95% CI) 9.7% (+/- 0.5) 6 Human West Nile Virus: New Cases (2008) 7 31 Hypertension: 2003-2007 3 Yr Average (95% CI) 30.7% (+/- 0.7) 8 Obesity: 2005-2007 3 Yr Average (95 % CI) 28.1% (+/-0.8) 8 Syphilis: Rates per 100,000 Population (2007) 1.8 28 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 25.3% (+/- 0.8) 3 Tuberculosis: Number of Cases (2007) 149 22 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 26 33 Asthma: High School Students (2007) 20.0% (+/- 1.8) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 21.5% 36 Infant Mortality: Per 1,000 Live Births (2005) 8.1 11 Low Birthweight: % of Total Births (2006) 8.3% 23 Obesity Rates, % High School Students (2007) 14.7% (+/- 1.9) N/A Obesity Rates, % Children Age 10-17 (2004) 15.4% 17 Pre-Term Labor: % of Live Births (2006) 13.9% 12 Tobacco: Current Smokers High School Students (2007) 31.3% (+/- 4.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 198 6 Health Professions Shortage Areas - Mental Health (FY 2008) 89 8 Health Professions Shortage Areas - Dental Care (FY 2008) 88 18 Nursing Shortage Estimates (2010) -500 43 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 28,000 27 Potential # of Episodes of Illness During a Severe Pandemic 1,046,000 28 Potential Financial Loss During a Severe Pandemic, % of GDP 5.55% 25 Potential Financial Loss During a Severe Pandemic, $ amount $6.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 95 THE STATE OF YOUR HEALTH: OKLAHOMA Public Health Funding Facts Federal Funding for Oklahoma’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $19.10 24 Health Resources and Services Administration (HRSA) FY 2008 $13.02 43 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.34 23 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $260,000 Cancer $4,243,840 Chronic Disease Prevention and Health Promotion $4,258,387 Diabetes $556,037 Environmental Health $481,250 Heart Disease $749,751 HIV/AIDS $3,347,476 Immunization (Sect. 317 and Vaccines for Children Program) $40,100,253 Infectious Diseases $592,380 Injury and Violence Prevention $1,099,710 Nutrition and Physical Activity $58,727 Occupational Safety and Health $157,450 Pandemic Flu $98,845 Preventive Health and Health Services Block Grant $914,484 School Health $408,088 Sexually Transmitted Diseases (STD) $712,504 Tobacco $1,093,550 Terrorism Preparedness and Emergency Response $9,266,029 Tuberculosis $784,028 Total FY 2008 CDC Dollars (All Categories) $69,582,765 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,030,585 HIV/AIDS $11,043,190 Maternal & Child Health $10,905,356 Primary Health Care $17,466,347 Total FY 2008 HRSA Dollars (All Categories) $47,103,686 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $4,837,520 Total FY 2008 ASPR HPP Dollars $4,837,520 State Spending State Per Capita Funding for Oklahoma’s Health: $66.36 State Per Capita Funding Ranking:8 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 96 THE STATE OF YOUR HEALTH: OREGON State Rank* U.S. Census Bureau 2008 Data Total Population 3,790,060 N/A % Uninsured, All Ages 16.8% 12 % Uninsured, 18 and under 10.6% 18 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 17.4% (+/- 0.7) 48 AIDS: Cumulative Cases Aged 13 & Over (2006) 5,995 27 Alzheimer’s Disease: Estimated Cases (2010) 76,000 26 Asthma: 2005-2007 3 Yr Average (95% CI) 15.4% (+/- 0.7) 2 Cancer: Estimated New Cases (2008) 19,230 26 Chlamydia: Rates per 100,000 Population (2007) 266.1 40 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.8% (+/- 0.4) 38 Human West Nile Virus: New Cases (2008) 16 21 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.5% (+/- 0.8) 37 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.0% (+/- 0.8) 29 Syphilis: Rates per 100,000 Population (2007) 0.5 47 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.0% (+/- 0.8) 43 Tuberculosis: Number of Cases (2007) 94 32 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 20 35 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 29.5% 8 Infant Mortality: Per 1,000 Live Births (2005) 5.9 38 Low Birthweight: % of Total Births (2006) 6.1% 50 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 14.1% 23 Pre-Term Labor: % of Live Births (2006) 10.3% 50 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 100 24 Health Professions Shortage Areas - Mental Health (FY 2008) 48 21 Health Professions Shortage Areas - Dental Care (FY 2008) 71 22 Nursing Shortage Estimates (2010) -5,300 21 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 28,000 29 Potential # of Episodes of Illness During a Severe Pandemic 1,082,000 27 Potential Financial Loss During a Severe Pandemic, % of GDP 5.46% 31 Potential Financial Loss During a Severe Pandemic, $ amount $7.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 97 THE STATE OF YOUR HEALTH: OREGON Public Health Funding Facts Federal Funding for Oregon’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $16.33 35 Health Resources and Services Administration (HRSA) FY 2008 $18.34 25 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.33 24 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $419,764 Birth Defects and Developmental Disabilities $1,129,406 Cancer $5,266,140 Chronic Disease Prevention and Health Promotion $1,823,202 Diabetes $792,792 Environmental Health $2,176,709 Heart Disease $342,102 HIV/AIDS $4,270,464 Immunization (Sect. 317 and Vaccines for Children Program) $25,634,976 Infectious Diseases $2,744,414 Injury and Violence Prevention $2,204,876 Nutrition and Physical Activity $0 Occupational Safety and Health $410,438 Pandemic Flu $1,858,263 Preventive Health and Health Services Block Grant $706,960 School Health $256,567 Sexually Transmitted Diseases (STD) $1,174,832 Tobacco $901,485 Terrorism Preparedness and Emergency Response $9,100,217 Tuberculosis $690,151 Total FY 2008 CDC Dollars (All Categories) $61,903,758 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $3,326,532 HIV/AIDS $12,250,128 Maternal & Child Health $10,507,348 Primary Health Care $37,745,017 Total FY 2008 HRSA Dollars (All Categories) $68,710,632 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $4,984,817 Total FY 2008 ASPR HPP Dollars $4,984,817 State Spending State Per Capita Funding for Oregon’s Health: $14.49 State Per Capita Funding Ranking:47 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 98 THE STATE OF YOUR HEALTH: PENNSYLVANIA State Rank* U.S. Census Bureau 2008 Data Total Population 12,448,279 N/A % Uninsured, All Ages 9.5% 43 % Uninsured, 18 and under 7.4% 35 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 24.0% (+/- 0.8) 21 AIDS: Cumulative Cases Aged 13 & Over (2006) 33,417 7 Alzheimer’s Disease: Estimated Cases (2010) 280,000 5 Asthma: 2005-2007 3 Yr Average (95% CI) 12.5% (+/- 0.6) 34 Cancer: Estimated New Cases (2008) 70,110 5 Chlamydia: Rates per 100,000 Population (2007) 341.4 27 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.4% (+/- 0.5) 16 Human West Nile Virus: New Cases (2008) 14 23 Hypertension: 2003-2007 3 Yr Average (95% CI) 28.2% (+/- 0.8) 18 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.7% (+/- 1.2) 24 Syphilis: Rates per 100,000 Population (2007) 2.1 25 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 22.0% (+/- 0.8) 16 Tuberculosis: Number of Cases (2007) 276 12 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 365 6 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 21.2% 38 Infant Mortality: Per 1,000 Live Births (2005) 7.3 20 Low Birthweight: % of Total Births (2006) 8.4% 21 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 13.3% 29 Pre-Term Labor: % of Live Births (2006) 11.8% 36 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 174 10 Health Professions Shortage Areas - Mental Health (FY 2008) 86 10 Health Professions Shortage Areas - Dental Care (FY 2008) 134 6 Nursing Shortage Estimates (2010) -21,100 5 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 113,000 5 Potential # of Episodes of Illness During a Severe Pandemic 3,675,000 6 Potential Financial Loss During a Severe Pandemic, % of GDP 5.50% 28 Potential Financial Loss During a Severe Pandemic, $ amount $26.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 99 THE STATE OF YOUR HEALTH: PENNSYLVANIA Public Health Funding Facts Federal Funding for Pennsylvania’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $13.99 45 Health Resources and Services Administration (HRSA) FY 2008 $15.97 34 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.25 43 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $495,515 Birth Defects and Developmental Disabilities $2,298,244 Cancer $4,264,271 Chronic Disease Prevention and Health Promotion $3,603,814 Diabetes $508,883 Environmental Health $3,477,551 Heart Disease $0 HIV/AIDS $17,898,647 Immunization (Sect. 317 and Vaccines for Children Program) $91,513,229 Infectious Diseases $2,721,483 Injury and Violence Prevention $6,646,094 Nutrition and Physical Activity $450,000 Occupational Safety and Health $1,342,386 Pandemic Flu $822,764 Preventive Health and Health Services Block Grant $4,757,441 School Health $656,831 Sexually Transmitted Diseases (STD) $4,671,911 Tobacco $1,062,934 Terrorism Preparedness and Emergency Response $25,549,169 Tuberculosis $1,382,824 Total FY 2008 CDC Dollars (All Categories) $174,123,991 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $12,756,745 HIV/AIDS $79,996,142 Maternal & Child Health $36,201,957 Primary Health Care $51,316,931 Total FY 2008 HRSA Dollars (All Categories) $198,609,748 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $15,576,347 Total FY 2008 ASPR HPP Dollars $15,576,347 State Spending State Per Capita Funding for Pennsylvania’s Health: $20.10 State Per Capita Funding Ranking:36 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 100 THE STATE OF YOUR HEALTH: RHODE ISLAND State Rank* U.S. Census Bureau 2008 Data Total Population 1,050,788 N/A % Uninsured, All Ages 10.8% 39 % Uninsured, 18 and under 8.8% 28 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 24.7% (+/- 1.0) 19 AIDS: Cumulative Cases Aged 13 & Over (2006) 2,580 38 Alzheimer’s Disease: Estimated Cases (2010) 24,000 42 Asthma: 2005-2007 3 Yr Average (95% CI) 15.3% (+/- 0.9) 3 Cancer: Estimated New Cases (2008) 6,120 43 Chlamydia: Rates per 100,000 Population (2007) 297.6 33 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.0% (+/- 0.5) 35 Human West Nile Virus: New Cases (2008) 1 39 Hypertension: 2003-2007 3 Yr Average (95% CI) 29.2% (+/- 1.0) 14 Obesity: 2005-2007 3 Yr Average (95 % CI) 21.4% (+/- 1.0) 46 Syphilis: Rates per 100,000 Population (2007) 3.4 18 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.7% (+/- 1.0) 37 Tuberculosis: Number of Cases (2007) 45 38 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 28 31 Asthma: High School Students (2007) 25.8% (+/- 1.8) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 25.0% 14 Infant Mortality: Per 1,000 Live Births (2005) 6.5 32 Low Birthweight: % of Total Births (2006) 8.0% 32 Obesity Rates, % High School Students (2007) 10.7% (+/- 2.2) N/A Obesity Rates, % Children Age 10-17 (2004) 11.9% 41 Pre-Term Labor: % of Live Births (2006) 12.6% 27 Tobacco: Current Smokers High School Students (2007) 21.6% (+/- 4.5) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 20 49 Health Professions Shortage Areas - Mental Health (FY 2008) 17 47 Health Professions Shortage Areas - Dental Care (FY 2008) 17 48 Nursing Shortage Estimates (2010) -3,000 30 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 9,000 41 Potential # of Episodes of Illness During a Severe Pandemic 318,000 43 Potential Financial Loss During a Severe Pandemic, % of GDP 5.29% 45 Potential Financial Loss During a Severe Pandemic, $ amount $2.3 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 101 THE STATE OF YOUR HEALTH: RHODE ISLAND Public Health Funding Facts Federal Funding for Rhode Island’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $32.09 4 Health Resources and Services Administration (HRSA) FY 2008 $24.60 11 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.70 8 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $309,884 Cancer $2,309,590 Chronic Disease Prevention and Health Promotion $369,179 Diabetes $799,263 Environmental Health $1,380,337 Heart Disease $606,633 HIV/AIDS $2,567,202 Immunization (Sect. 317 and Vaccines for Children Program) $14,734,033 Infectious Diseases $683,279 Injury and Violence Prevention $688,136 Nutrition and Physical Activity $821,857 Occupational Safety and Health $0 Pandemic Flu $763,323 Preventive Health and Health Services Block Grant $601,499 School Health $444,471 Sexually Transmitted Diseases (STD) $405,601 Tobacco $949,656 Terrorism Preparedness and Emergency Response $4,842,787 Tuberculosis $441,409 Total FY 2008 CDC Dollars (All Categories) $33,718,139 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,673,061 HIV/AIDS $5,765,240 Maternal & Child Health $2,953,614 Primary Health Care $11,800,300 Total FY 2008 HRSA Dollars (All Categories) $26,025,026 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,793,799 Total FY 2008 ASPR HPP Dollars $1,793,799 State Spending State Per Capita Funding for Rhode Island’s Health: $50.56 State Per Capita Funding Ranking:15 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 102 THE STATE OF YOUR HEALTH: SOUTH CAROLINA State Rank* U.S. Census Bureau 2008 Data Total Population 4,479,800 N/A % Uninsured, All Ages 16.4% 13 % Uninsured, 18 and under 14.2% 5 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 25.1% (+/- 0.7) 16 AIDS: Cumulative Cases Aged 13 & Over (2006) 13,301 18 Alzheimer’s Disease: Estimated Cases (2010) 80,000 24 Asthma: 2005-2007 3 Yr Average (95% CI) 11.9% (+/- 0.6) 40 Cancer: Estimated New Cases (2008) 20,740 25 Chlamydia: Rates per 100,000 Population (2007) 611.7 4 Diabetes: 2005-2007 3 Yr Average (95% CI) 9.8% (+/- 0.5) 5 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 31.3% (+/- 0.7) 6 Obesity: 2005-2007 3 Yr Average (95 % CI) 29.2% (+/- 0.8) 5 Syphilis: Rates per 100,000 Population (2007) 2.1 25 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 22.2% (+/- 0.7) 15 Tuberculosis: Number of Cases (2007) 218 19 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 105 18 Asthma: High School Students (2007) 22.5% (+/- 2.3) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 20.5% 40 Infant Mortality: Per 1,000 Live Births (2005) 9.4 4 Low Birthweight: % of Total Births (2006) 10.1% 5 Obesity Rates, % High School Students (2007) 14.4% (+/- 2.9) N/A Obesity Rates, % Children Age 10-17 (2004) 18.9% 7 Pre-Term Labor: % of Live Births (2006) 15.4% 5 Tobacco: Current Smokers High School Students (2007) 24.2% (+/- 3.9) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 88 31 Health Professions Shortage Areas - Mental Health (FY 2008) 42 31 Health Professions Shortage Areas - Dental Care (FY 2008) 66 25 Nursing Shortage Estimates (2010) -5,200 22 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 31,000 25 Potential # of Episodes of Illness During a Severe Pandemic 1,256,000 25 Potential Financial Loss During a Severe Pandemic, % of GDP 5.62% 20 Potential Financial Loss During a Severe Pandemic, $ amount $ 7.9 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 103 THE STATE OF YOUR HEALTH: SOUTH CAROLINA Public Health Funding Facts Federal Funding for South Carolina’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $18.69 26 Health Resources and Services Administration (HRSA) FY 2008 $23.90 15 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.30 28 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $1,243,330 Cancer $5,025,374 Chronic Disease Prevention and Health Promotion $3,899,652 Diabetes $989,549 Environmental Health $150,000 Heart Disease $1,100,000 HIV/AIDS $7,765,867 Immunization (Sect. 317 and Vaccines for Children Program) $43,089,987 Infectious Diseases $793,513 Injury and Violence Prevention $1,996,408 Nutrition and Physical Activity $1,059,557 Occupational Safety and Health $66,419 Pandemic Flu $411,488 Preventive Health and Health Services Block Grant $1,194,141 School Health $894,399 Sexually Transmitted Diseases (STD) $1,316,862 Tobacco $1,003,690 Terrorism Preparedness and Emergency Response $10,494,629 Tuberculosis $1,233,499 Total FY 2008 CDC Dollars (All Categories) $83,728,364 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $4,532,803 HIV/AIDS $35,611,912 Maternal & Child Health $15,301,521 Primary Health Care $45,292,976 Total FY 2008 HRSA Dollars (All Categories) $105,340,508 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $5,736,768 Total FY 2008 ASPR HPP Dollars $5,736,768 State Spending State Per Capita Funding for South Carolina’s Health: $40.96 State Per Capita Funding Ranking:22 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 104 THE STATE OF YOUR HEALTH: SOUTH DAKOTA State Rank* U.S. Census Bureau 2008 Data Total Population 804,194 N/A % Uninsured, All Ages 10.1% 41 % Uninsured, 18 and under 8.0% 30 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 23.0% (+/- 0.8) 25 AIDS: Cumulative Cases Aged 13 & Over (2006) 255 49 Alzheimer’s Disease: Estimated Cases (2010) 19,000 45 Asthma: 2005-2007 3 Yr Average (95% CI) 10.5% (+/- 0.6) 50 Cancer: Estimated New Cases (2008) 4,080 46 Chlamydia: Rates per 100,000 Population (2007) 335.1 28 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.5% (+/- 0.4) 44 Human West Nile Virus: New Cases (2008) 39 9 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.8% (+/- 0.7) 33 Obesity: 2005-2007 3 Yr Average (95 % CI) 26.1% (+/- 0.9) 20 Syphilis: Rates per 100,000 Population (2007) 0.9 39 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.0% (+/- 0.8) 28 Tuberculosis: Number of Cases (2007) 13 45 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 5 47 Asthma: High School Students (2007) 16.1% (+/- 2.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 23.1% 22 Infant Mortality: Per 1,000 Live Births (2005) 7.2 22 Low Birthweight: % of Total Births (2006) 7.0% 38 Obesity Rates, % High School Students (2007) 9.1% (+/- 2.6) N/A Obesity Rates, % Children Age 10-17 (2004) 12.1% 39 Pre-Term Labor: % of Live Births (2006) 12.7% 26 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 91 28 Health Professions Shortage Areas - Mental Health (FY 2008) 44 28 Health Professions Shortage Areas - Dental Care (FY 2008) 50 34 Nursing Shortage Estimates (2010) -200 46 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 6,000 47 Potential # of Episodes of Illness During a Severe Pandemic 229,000 46 Potential Financial Loss During a Severe Pandemic, % of GDP 5.71% 16 Potential Financial Loss During a Severe Pandemic, $ amount $1.8 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 105 THE STATE OF YOUR HEALTH: SOUTH DAKOTA Public Health Funding Facts Federal Funding for South Dakota’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $29.12 6 Health Resources and Services Administration (HRSA) FY 2008 $26.94 10 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.82 5 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $372,339 Cancer $2,467,299 Chronic Disease Prevention and Health Promotion $321,981 Diabetes $189,569 Environmental Health $0 Heart Disease $0 HIV/AIDS $827,035 Immunization (Sect. 317 and Vaccines for Children Program) $11,357,597 Infectious Diseases $720,171 Injury and Violence Prevention $104,705 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $56,905 Preventive Health and Health Services Block Grant $226,162 School Health $645,000 Sexually Transmitted Diseases (STD) $211,686 Tobacco $793,727 Terrorism Preparedness and Emergency Response $4,893,439 Tuberculosis $234,436 Total FY 2008 CDC Dollars (All Categories) $23,422,051 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,053,672 HIV/AIDS $1,173,798 Maternal & Child Health $4,369,089 Primary Health Care $8,623,110 Total FY 2008 HRSA Dollars (All Categories) $21,448,721 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,447,580 Total FY 2008 ASPR HPP Dollars $1,447,580 State Spending State Per Capita Funding for South Dakota’s Health: $28.49 State Per Capita Funding Ranking:28 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 106 THE STATE OF YOUR HEALTH: TENNESSEE State Rank* U.S. Census Bureau 2008 Data Total Population 6,214,888 N/A % Uninsured, All Ages 14.4% 20 % Uninsured, 18 and under 9.1% 26 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 31.1% (+/- 1.1) 3 AIDS: Cumulative Cases Aged 13 & Over (2006) 12,457 19 Alzheimer’s Disease: Estimated Cases (2010) 120,000 12 Asthma: 2005-2007 3 Yr Average (95% CI) 11.9% (+/- 0.8) 39 Cancer: Estimated New Cases (2008) 29,390 16 Chlamydia: Rates per 100,000 Population (2007) 444.9 9 Diabetes: 2005-2007 3 Yr Average (95% CI) 10.6% (+/- 0.7) 2 Human West Nile Virus: New Cases (2008) 17 19 Hypertension: 2003-2007 3 Yr Average (95% CI) 32.1% (+/- 1.1) 4 Obesity: 2005-2007 3 Yr Average (95 % CI) 29.0% (+/- 1.2) 6 Syphilis: Rates per 100,000 Population (2007) 6.1 5 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 24.5% (+/- 1.1) 5 Tuberculosis: Number of Cases (2007) 234 16 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 59 21 Asthma: High School Students (2007) 20.2% (+/- 2.1) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 21.3% 37 Infant Mortality: Per 1,000 Live Births (2005) 8.9 7 Low Birthweight: % of Total Births (2006) 9.6% 7 Obesity Rates, % High School Students (2007) 16.9% (+/- 2.0) N/A Obesity Rates, % Children Age 10-17 (2004) 20.0% 4 Pre-Term Labor: % of Live Births (2006) 14.8% 7 Tobacco: Current Smokers High School Students (2007) 32.8% (+/- 4.2) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 120 15 Health Professions Shortage Areas - Mental Health (FY 2008) 48 21 Health Professions Shortage Areas - Dental Care (FY 2008) 126 8 Nursing Shortage Estimates (2010) -18,500 7 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 45,000 16 Potential # of Episodes of Illness During a Severe Pandemic 1,767,000 16 Potential Financial Loss During a Severe Pandemic, % of GDP 5.98% 8 Potential Financial Loss During a Severe Pandemic, $ amount $13.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 107 THE STATE OF YOUR HEALTH: TENNESSEE Public Health Funding Facts Federal Funding for Tennessee’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $14.96 44 Health Resources and Services Administration (HRSA) FY 2008 $17.04 30 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.27 37 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $162,408 Birth Defects and Developmental Disabilities $2,122,000 Cancer $2,098,961 Chronic Disease Prevention and Health Promotion $591,465 Diabetes $143,462 Environmental Health $251,294 Heart Disease $350,000 HIV/AIDS $6,096,768 Immunization (Sect. 317 and Vaccines for Children Program) $56,949,758 Infectious Diseases $2,465,003 Injury and Violence Prevention $1,988,161 Nutrition and Physical Activity $457,522 Occupational Safety and Health $175,000 Pandemic Flu $308,230 Preventive Health and Health Services Block Grant $1,580,945 School Health $524,387 Sexually Transmitted Diseases (STD) $2,280,218 Tobacco $1,040,809 Terrorism Preparedness and Emergency Response $11,842,828 Tuberculosis $1,531,663 Total FY 2008 CDC Dollars (All Categories) $92,960,882 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $15,146,655 HIV/AIDS $31,782,146 Maternal & Child Health $15,788,258 Primary Health Care $36,164,437 Total FY 2008 HRSA Dollars (All Categories) $104,890,871 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $7,818,211 Total FY 2008 ASPR HPP Dollars $7,818,211 State Spending State Per Capita Funding for Tennessee’s Health: $50.92 State Per Capita Funding Ranking:14 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 108 THE STATE OF YOUR HEALTH: TEXAS State Rank* U.S. Census Bureau 2008 Data Total Population 24,326,974 N/A % Uninsured, All Ages 25.2% 1 % Uninsured, 18 and under 21.4% 1 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 28.1% (+/- 0.9) 8 AIDS: Cumulative Cases Aged 13 & Over (2006) 69,735 4 Alzheimer’s Disease: Estimated Cases (2010) 340,000 3 Asthma: 2005-2007 3 Yr Average (95% CI) 12.2% (+/- 0.7) 35 Cancer: Estimated New Cases (2008) 96,320 4 Chlamydia: Rates per 100,000 Population (2007) 364.9 21 Diabetes: 2005-2007 3 Yr Average (95% CI) 8.8% (+/- 0.5) 11 Human West Nile Virus: New Cases (2008) 62 5 Hypertension: 2003-2007 3 Yr Average (95% CI) 26.9% (+/- 0.7) 27 Obesity: 2005-2007 3 Yr Average (95 % CI) 27.2% (+/- 0.9) 15 Syphilis: Rates per 100,000 Population (2007) 4.9 10 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.1% (+/- 0.8) 35 Tuberculosis: Number of Cases (2007) 1510 2 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 392 5 Asthma: High School Students (2007) 19.7% (+/- 2.4) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.7% 28 Infant Mortality: Per 1,000 Live Births (2005) 6.6 29 Low Birthweight: % of Total Births (2006) 8.4% 21 Obesity Rates, % High School Students (2007) 15.9% (+/- 2.1) N/A Obesity Rates, % Children Age 10-17 (2004) 19.1% 6 Pre-Term Labor: % of Live Births (2006) 13.7% 14 Tobacco: Current Smokers High School Students (2007) 26.8% (+/- 3.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 407 2 Health Professions Shortage Areas - Mental Health (FY 2008) 272 1 Health Professions Shortage Areas - Dental Care (FY 2008) 218 2 Nursing Shortage Estimates (2010) -41,900 2 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 146,000 4 Potential # of Episodes of Illness During a Severe Pandemic 6,789,000 2 Potential Financial Loss During a Severe Pandemic, % of GDP 5.57% 23 Potential Financial Loss During a Severe Pandemic, $ amount $55.1 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 109 THE STATE OF YOUR HEALTH: TEXAS Public Health Funding Facts Federal Funding for Texas’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $17.16 31 Health Resources and Services Administration (HRSA) FY 2008 $14.27 39 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.21 47 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $273,805 Birth Defects and Developmental Disabilities $2,162,678 Cancer $11,128,352 Chronic Disease Prevention and Health Promotion $3,459,124 Diabetes $1,317,818 Environmental Health $1,508,763 Heart Disease $547,158 HIV/AIDS $33,877,565 Immunization (Sect. 317 and Vaccines for Children Program) $290,455,138 Infectious Diseases $2,641,841 Injury and Violence Prevention $3,445,513 Nutrition and Physical Activity $777,346 Occupational Safety and Health $889,773 Pandemic Flu $957,310 Preventive Health and Health Services Block Grant $4,237,055 School Health $647,580 Sexually Transmitted Diseases (STD) $6,157,007 Tobacco $796,499 Terrorism Preparedness and Emergency Response $43,211,012 Tuberculosis $8,952,835 Total FY 2008 CDC Dollars (All Categories) $417,444,172 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $15,741,632 HIV/AIDS $150,053,709 Maternal & Child Health $42,128,869 Primary Health Care $114,240,000 Total FY 2008 HRSA Dollars (All Categories) $341,164,609 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $28,988,249 Total FY 2008 ASPR HPP Dollars $28,988,249 State Spending State Per Capita Funding for Texas’s Health: $15.96 State Per Capita Funding Ranking:44 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 110 THE STATE OF YOUR HEALTH: UTAH State Rank* U.S. Census Bureau 2008 Data Total Population 2,736,424 N/A % Uninsured, All Ages 12.8% 29 % Uninsured, 18 and under 10.4% 21 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 19.1% (+/- 0.8) 44 AIDS: Cumulative Cases Aged 13 & Over (2006) 2,295 39 Alzheimer’s Disease: Estimated Cases (2010) 32,000 36 Asthma: 2005-2007 3 Yr Average (95% CI) 13.3% (+/- 0.8) 19 Cancer: Estimated New Cases (2008) 7,760 39 Chlamydia: Rates per 100,000 Population (2007) 224.3 46 Diabetes: 2005-2007 3 Yr Average (95% CI) 5.7% (+/- 0.4) 49 Human West Nile Virus: New Cases (2008) 26 13 Hypertension: 2003-2007 3 Yr Average (95% CI) 20.3% (+/- 0.8) 51 Obesity: 2005-2007 3 Yr Average (95 % CI) 21.8% (+/- 0.9) 44 Syphilis: Rates per 100,000 Population (2007) 0.8 41 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 11.0% (+/- 0.7) 51 Tuberculosis: Number of Cases (2007) 39 40 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 20 35 Asthma: High School Students (2007) 22.7% (+/- 4.6) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 26.4% 12 Infant Mortality: Per 1,000 Live Births (2005) 4.5 51 Low Birthweight: % of Total Births (2006) 6.9% 39 Obesity Rates, % High School Students (2007) 8.7% (+/- 3.8) N/A Obesity Rates, % Children Age 10-17 (2004) 8.5% 51 Pre-Term Labor: % of Live Births (2006) 11.5% 40 Tobacco: Current Smokers High School Students (2007) 8.9% (+/- 3.4) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 59 40 Health Professions Shortage Areas - Mental Health (FY 2008) 31 37 Health Professions Shortage Areas - Dental Care (FY 2008) 47 35 Nursing Shortage Estimates (2010) -1,500 36 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 14,000 36 Potential # of Episodes of Illness During a Severe Pandemic 737,000 34 Potential Financial Loss During a Severe Pandemic, % of GDP 5.49% 29 Potential Financial Loss During a Severe Pandemic, $ amount $5.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 111 THE STATE OF YOUR HEALTH: UTAH Public Health Funding Facts Federal Funding for Utah’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $15.73 39 Health Resources and Services Administration (HRSA) FY 2008 $14.02 40 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.36 21 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $157,731 Birth Defects and Developmental Disabilities $811,569 Cancer $3,486,527 Chronic Disease Prevention and Health Promotion $1,628,367 Diabetes $968,268 Environmental Health $1,215,352 Heart Disease $948,335 HIV/AIDS $1,281,571 Immunization (Sect. 317 and Vaccines for Children Program) $17,637,574 Infectious Diseases $1,276,824 Injury and Violence Prevention $684,230 Nutrition and Physical Activity $464,953 Occupational Safety and Health $767,057 Pandemic Flu $404,292 Preventive Health and Health Services Block Grant $1,008,736 School Health $0 Sexually Transmitted Diseases (STD) $481,402 Tobacco $1,001,838 Terrorism Preparedness and Emergency Response $8,457,508 Tuberculosis $320,170 Total FY 2008 CDC Dollars (All Categories) $43,052,657 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,970,356 HIV/AIDS $5,284,977 Maternal & Child Health $13,370,474 Primary Health Care $13,197,219 Total FY 2008 HRSA Dollars (All Categories) $37,100,062 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $3,590,331 Total FY 2008 ASPR HPP Dollars $3,590,331 State Spending State Per Capita Funding for Utah’s Health: $33.71 State Per Capita Funding Ranking:26 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 112 THE STATE OF YOUR HEALTH: VERMONT State Rank* U.S. Census Bureau 2008 Data Total Population 621,270 N/A % Uninsured, All Ages 11.2% 37 % Uninsured, 18 and under 9.4% 25 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 18.5% (+/- 0.7) 47 AIDS: Cumulative Cases Aged 13 & Over (2006) 461 47 Alzheimer’s Disease: Estimated Cases (2010) 11,000 48 Asthma: 2005-2007 3 Yr Average (95% CI) 14.4% (+/- 0.7) 9 Cancer: Estimated New Cases (2008) 3,530 47 Chlamydia: Rates per 100,000 Population (2007) 169.4 50 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.3% (+/- 0.4) 46 Human West Nile Virus: New Cases (2008) 0 43 Hypertension: 2003-2007 3 Yr Average (95% CI) 24.6% (+/- 0.8) 44 Obesity: 2005-2007 3 Yr Average (95 % CI) 21.1% (+/- 0.7) 47 Syphilis: Rates per 100,000 Population (2007) 1.6 30 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 18.3% (+/- 0.7) 41 Tuberculosis: Number of Cases (2007) 3 50 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 6 46 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 32.7% 4 Infant Mortality: Per 1,000 Live Births (2005) 6.7 28 Low Birthweight: % of Total Births (2006) 6.9% 39 Obesity Rates, % High School Students (2007) 11.8% (+/-3.3) N/A Obesity Rates, % Children Age 10-17 (2004) 11.3% 43 Pre-Term Labor: % of Live Births (2006) 9.6% 51 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 25 47 Health Professions Shortage Areas - Mental Health (FY 2008) 15 49 Health Professions Shortage Areas - Dental Care (FY 2008) 16 49 Nursing Shortage Estimates (2010) -600 42 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 5,000 49 Potential # of Episodes of Illness During a Severe Pandemic 185,000 49 Potential Financial Loss During a Severe Pandemic, % of GDP 5.65% 19 Potential Financial Loss During a Severe Pandemic, $ amount $1.3 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 113 THE STATE OF YOUR HEALTH: VERMONT Public Health Funding Facts Federal Funding for Vermont’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $35.15 2 Health Resources and Services Administration (HRSA) FY 2008 $22.80 17 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $2.02 2 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $149,757 Cancer $2,374,658 Chronic Disease Prevention and Health Promotion $149,588 Diabetes $272,336 Environmental Health $737,290 Heart Disease $213,896 HIV/AIDS $1,587,771 Immunization (Sect. 317 and Vaccines for Children Program) $8,974,954 Infectious Diseases $502,412 Injury and Violence Prevention $201,641 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $72,922 Preventive Health and Health Services Block Grant $263,811 School Health $194,999 Sexually Transmitted Diseases (STD) $161,819 Tobacco $939,747 Terrorism Preparedness and Emergency Response $4,901,506 Tuberculosis $136,520 Total FY 2008 CDC Dollars (All Categories) $21,835,627 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $507,945 HIV/AIDS $1,404,236 Maternal & Child Health $3,373,669 Primary Health Care $6,240,081 Total FY 2008 HRSA Dollars (All Categories) $14,165,229 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,256,092 Total FY 2008 ASPR HPP Dollars $1,256,092 State Spending State Per Capita Funding for Vermont’s Health: $145.23 State Per Capita Funding Ranking:2 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 114 THE STATE OF YOUR HEALTH: VIRGINIA State Rank* U.S. Census Bureau 2008 Data Total Population 7,769,089 N/A % Uninsured, All Ages 14.8% 19 % Uninsured, 18 and under 10.2% 22 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 21.6% (+/- 0.9) 37 AIDS: Cumulative Cases Aged 13 & Over (2006) 16,802 13 Alzheimer’s Disease: Estimated Cases (2010) 130,000 11 Asthma: 2005-2007 3 Yr Average (95% CI) 13.7% (+/- 0.9) 12 Cancer: Estimated New Cases (2008) 35,590 12 Chlamydia: Rates per 100,000 Population (2007) 321.6 31 Diabetes: 2005-2007 3 Yr Average (95% CI) 7.4% (+/- 0.5) 30 Human West Nile Virus: New Cases (2008) 1 39 Hypertension: 2003-2007 3 Yr Average (95% CI) 27.3% (+/- 1.0) 23 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.2% (+/- 1.1) 27 Syphilis: Rates per 100,000 Population (2007) 3.0 19 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 19.5% (+/- 1.0) 30 Tuberculosis: Number of Cases (2007) 309 9 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 177 13 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 24.5% 16 Infant Mortality: Per 1,000 Live Births (2005) 7.5 16 Low Birthweight: % of Total Births (2006) 8.3% 23 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 13.8% 25 Pre-Term Labor: % of Live Births (2006) 12.0% 34 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 117 18 Health Professions Shortage Areas - Mental Health (FY 2008) 73 12 Health Professions Shortage Areas - Dental Care (FY 2008) 90 17 Nursing Shortage Estimates (2010) -11,000 14 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 54,000 13 Potential # of Episodes of Illness During a Severe Pandemic 2,208,000 12 Potential Financial Loss During a Severe Pandemic, % of GDP 5.13% 49 Potential Financial Loss During a Severe Pandemic, $ amount $18.1 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 115 THE STATE OF YOUR HEALTH: VIRGINIA Public Health Funding Facts Federal Funding for Virginia’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $12.88 48 Health Resources and Services Administration (HRSA) FY 2008 $13.39 42 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.27 37 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $1,103,368 Cancer $5,311,174 Chronic Disease Prevention and Health Promotion $2,630,719 Diabetes $410,742 Environmental Health $1,380,284 Heart Disease $1,010,000 HIV/AIDS $8,264,939 Immunization (Sect. 317 and Vaccines for Children Program) $44,928,243 Infectious Diseases $2,391,569 Injury and Violence Prevention $2,930,250 Nutrition and Physical Activity $0 Occupational Safety and Health $641,557 Pandemic Flu $2,415,584 Preventive Health and Health Services Block Grant $2,249,425 School Health $2,062,210 Sexually Transmitted Diseases (STD) $1,817,815 Tobacco $879,582 Terrorism Preparedness and Emergency Response $17,773,879 Tuberculosis $1,078,659 Total FY 2008 CDC Dollars (All Categories) $100,068,077 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $5,195,041 HIV/AIDS $37,478,195 Maternal & Child Health $16,271,836 Primary Health Care $39,449,204 Total FY 2008 HRSA Dollars (All Categories) $103,240,575 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $9,762,140 Total FY 2008 ASPR HPP Dollars $9,762,140 State Spending State Per Capita Funding for Virginia’s Health: $41.59 State Per Capita Funding Ranking:20 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 116 THE STATE OF YOUR HEALTH: WASHINGTON State Rank* U.S. Census Bureau 2008 Data Total Population 6,549,224 N/A % Uninsured, All Ages 11.3% 36 % Uninsured, 18 and under 6.8% 37 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 17.4% (+/- 0.4) 49 AIDS: Cumulative Cases Aged 13 & Over (2006) 11,792 20 Alzheimer’s Disease: Estimated Cases (2010) 110,000 16 Asthma: 2005-2007 3 Yr Average (95% CI) 14.6% (+/- 0.4) 8 Cancer: Estimated New Cases (2008) 32,380 14 Chlamydia: Rates per 100,000 Population (2007) 293.7 35 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.8% (+/- 0.3) 40 Human West Nile Virus: New Cases (2008) 2 37 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.4% (+/- 0.4) 40 Obesity: 2005-2007 3 Yr Average (95 % CI) 24.5% (+/- 0.5) 32 Syphilis: Rates per 100,000 Population (2007) 2.4 21 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 17.1% (+/- 0.5) 48 Tuberculosis: Number of Cases (2007) 291 11 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 34 26 Asthma: High School Students (2007) N/A N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 31.0% 5 Infant Mortality: Per 1,000 Live Births (2005) 5.1 49 Low Birthweight: % of Total Births (2006) 6.5% 48 Obesity Rates, % High School Students (2007) N/A N/A Obesity Rates, % Children Age 10-17 (2004) 10.8% 46 Pre-Term Labor: % of Live Births (2006) 11.0% 45 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 144 11 Health Professions Shortage Areas - Mental Health (FY 2008) 103 7 Health Professions Shortage Areas - Dental Care (FY 2008) 103 12 Nursing Shortage Estimates (2010) -8,800 17 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 45,000 16 Potential # of Episodes of Illness During a Severe Pandemic 1,853,000 15 Potential Financial Loss During a Severe Pandemic, % of GDP 5.36% 41 Potential Financial Loss During a Severe Pandemic, $ amount $14.3 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 117 THE STATE OF YOUR HEALTH: WASHINGTON Public Health Funding Facts Federal Funding for Washington’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $21.34 15 Health Resources and Services Administration (HRSA) FY 2008 $24.24 12 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.28 35 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $641,112 Birth Defects and Developmental Disabilities $460,694 Cancer $7,823,053 Chronic Disease Prevention and Health Promotion $2,574,411 Diabetes $1,436,509 Environmental Health $1,481,017 Heart Disease $1,433,887 HIV/AIDS $6,584,548 Immunization (Sect. 317 and Vaccines for Children Program) $84,682,351 Infectious Diseases $1,518,678 Injury and Violence Prevention $2,556,079 Nutrition and Physical Activity $1,042,746 Occupational Safety and Health $2,506,154 Pandemic Flu $264,378 Preventive Health and Health Services Block Grant $1,035,325 School Health $899,622 Sexually Transmitted Diseases (STD) $3,292,064 Tobacco $1,163,230 Terrorism Preparedness and Emergency Response $16,877,379 Tuberculosis $1,451,949 Total FY 2008 CDC Dollars (All Categories) $139,782,186 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $8,657,229 HIV/AIDS $71,672,321 Maternal & Child Health $12,926,982 Primary Health Care $54,422,376 Total FY 2008 HRSA Dollars (All Categories) $156,787,361 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $8,250,841 Total FY 2008 ASPR HPP Dollars $8,250,841 State Spending State Per Capita Funding for Washington’s Health: $41.53 State Per Capita Funding Ranking:21 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 118 THE STATE OF YOUR HEALTH: WEST VIRGINIA State Rank* U.S. Census Bureau 2008 Data Total Population 1,814,468 N/A % Uninsured, All Ages 14.1% 21 % Uninsured, 18 and under 4.6% 50 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 27.5% (+/- 1.0) 9 AIDS: Cumulative Cases Aged 13 & Over (2006) 1,500 41 Alzheimer’s Disease: Estimated Cases (2010) 44,000 34 Asthma: 2005-2007 3 Yr Average (95% CI) 12.5% (+/- 0.8) 32 Cancer: Estimated New Cases (2008) 10,250 35 Chlamydia: Rates per 100,000 Population (2007) 174.2 49 Diabetes: 2005-2007 3 Yr Average (95% CI) 11.1% (+/- 0.6) 1 Human West Nile Virus: New Cases (2008) 1 39 Hypertension: 2003-2007 3 Yr Average (95% CI) 33.2% (+/- 1.0) 3 Obesity: 2005-2007 3 Yr Average (95 % CI) 30.6% (+/- 1.1) 2 Syphilis: Rates per 100,000 Population (2007) 0.3 48 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 26.4% (+/- 1.0) 2 Tuberculosis: Number of Cases (2007) 24 42 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 11 40 Asthma: High School Students (2007) 24.6% (+/- 3.3) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 24.5% 16 Infant Mortality: Per 1,000 Live Births (2005) 8.1 11 Low Birthweight: % of Total Births (2006) 9.7% 6 Obesity Rates, % High School Students (2007) 14.7% (+/- 2.4) N/A Obesity Rates, % Children Age 10-17 (2004) 20.9% 2 Pre-Term Labor: % of Live Births (2006) 14.0% 11 Tobacco: Current Smokers High School Students (2007) 34.5% (+/- 4.4) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 98 25 Health Professions Shortage Areas - Mental Health (FY 2008) 53 16 Health Professions Shortage Areas - Dental Care (FY 2008) 65 27 Nursing Shortage Estimates (2010) 700 50 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 17,000 34 Potential # of Episodes of Illness During a Severe Pandemic 537,000 37 Potential Financial Loss During a Severe Pandemic, % of GDP 5.69% 18 Potential Financial Loss During a Severe Pandemic, $ amount $3.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 119 THE STATE OF YOUR HEALTH: WEST VIRGINIA Public Health Funding Facts Federal Funding for West Virginia’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $21.78 13 Health Resources and Services Administration (HRSA) FY 2008 $34.24 6 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.49 13 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $51,557 Birth Defects and Developmental Disabilities $0 Cancer $5,724,740 Chronic Disease Prevention and Health Promotion $1,474,171 Diabetes $890,052 Environmental Health $399,073 Heart Disease $629,657 HIV/AIDS $1,693,638 Immunization (Sect. 317 and Vaccines for Children Program) $16,241,906 Infectious Diseases $601,366 Injury and Violence Prevention $1,106,200 Nutrition and Physical Activity $642,706 Occupational Safety and Health $405,900 Pandemic Flu $135,459 Preventive Health and Health Services Block Grant $980,637 School Health $624,696 Sexually Transmitted Diseases (STD) $678,572 Tobacco $965,109 Terrorism Preparedness and Emergency Response $5,933,288 Tuberculosis $336,453 Total FY 2008 CDC Dollars (All Categories) $39,515,180 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $2,285,093 HIV/AIDS $3,266,254 Maternal & Child Health $8,408,245 Primary Health Care $26,164,036 Total FY 2008 HRSA Dollars (All Categories) $62,039,237 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $2,703,739 Total FY 2008 ASPR HPP Dollars $2,703,739 State Spending State Per Capita Funding for West Virginia’s Health: $76.93 State Per Capita Funding Ranking:6 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 120 THE STATE OF YOUR HEALTH: WISCONSIN State Rank* U.S. Census Bureau 2008 Data Total Population 5,627,967 N/A % Uninsured, All Ages 8.2% 49 % Uninsured, 18 and under 5.8% 44 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 19.1% (+/- 0.8) 44 AIDS: Cumulative Cases Aged 13 & Over (2006) 4,513 32 Alzheimer’s Disease: Estimated Cases (2010) 110,000 16 Asthma: 2005-2007 3 Yr Average (95% CI) 12.9% (+/- 0.8) 22 Cancer: Estimated New Cases (2008) 27,590 18 Chlamydia: Rates per 100,000 Population (2007) 351.9 24 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.4% (+/- 0.4) 45 Human West Nile Virus: New Cases (2008) 7 31 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.9% (+/- 0.9) 32 Obesity: 2005-2007 3 Yr Average (95 % CI) 25.5% (+/- 1.0) 25 Syphilis: Rates per 100,000 Population (2007) 1.2 32 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 20.4% (+/- 0.9) 24 Tuberculosis: Number of Cases (2007) 70 33 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 33 27 Asthma: High School Students (2007) 21.5% (+/- 1.9) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 22.9% 24 Infant Mortality: Per 1,000 Live Births (2005) 6.6 29 Low Birthweight: % of Total Births (2006) 6.9% 39 Obesity Rates, % High School Students (2007) 11.1% (+/- 1.6) N/A Obesity Rates, % Children Age 10-17 (2004) 13.5% 28 Pre-Term Labor: % of Live Births (2006) 11.4% 41 Tobacco: Current Smokers High School Students (2007) 27.5% (+/- 2.0) N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not- Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 110 21 Health Professions Shortage Areas - Mental Health (FY 2008) 104 6 Health Professions Shortage Areas - Dental Care (FY 2008) 72 21 Nursing Shortage Estimates (2010) 500 49 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 44,000 18 Potential # of Episodes of Illness During a Severe Pandemic 1,643,000 20 Potential Financial Loss During a Severe Pandemic, % of GDP 5.56% 24 Potential Financial Loss During a Severe Pandemic, $ amount $12.0 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 121 THE STATE OF YOUR HEALTH: WISCONSIN Public Health Funding Facts Federal Funding for Wisconsin’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $14.97 43 Health Resources and Services Administration (HRSA) FY 2008 $11.28 46 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $1.29 31 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $574,038 Birth Defects and Developmental Disabilities $1,844,432 Cancer $4,862,589 Chronic Disease Prevention and Health Promotion $1,997,826 Diabetes $919,067 Environmental Health $3,577,769 Heart Disease $618,457 HIV/AIDS $3,791,055 Immunization (Sect. 317 and Vaccines for Children Program) $43,584,637 Infectious Diseases $1,196,705 Injury and Violence Prevention $2,952,773 Nutrition and Physical Activity $833,805 Occupational Safety and Health $248,100 Pandemic Flu $171,945 Preventive Health and Health Services Block Grant $1,896,411 School Health $664,878 Sexually Transmitted Diseases (STD) $1,093,182 Tobacco $981,707 Terrorism Preparedness and Emergency Response $12,060,242 Tuberculosis $406,564 Total FY 2008 CDC Dollars (All Categories) $84,276,182 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $6,322,762 HIV/AIDS $13,108,022 Maternal & Child Health $16,270,480 Primary Health Care $19,066,590 Total FY 2008 HRSA Dollars (All Categories) $63,205,970 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $7,233,733 Total FY 2008 ASPR HPP Dollars $7,233,733 State Spending State Per Capita Funding for Wisconsin’s Health: $10.51 State Per Capita Funding Ranking:49 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 122 THE STATE OF YOUR HEALTH: WYOMING State Rank* U.S. Census Bureau 2008 Data Total Population 532,668 N/A % Uninsured, All Ages 13.6% 24 % Uninsured, 18 and under 9.6% 24 *Note: For rankings, 1 = Worst Outcome. 1 = Highest Rate of Uninsured All Ages and 18 and under. Adult Health Indicators Adult Physical Inactivity: 2005-2007 3 Yr Average (95% CI) 21.8% (+/- 0.8) 35 AIDS: Cumulative Cases Aged 13 & Over (2006) 228 50 Alzheimer’s Disease: Estimated Cases (2010) 10,000 49 Asthma: 2005-2007 3 Yr Average (95% CI) 12.8% (+/- 0.7) 25 Cancer: Estimated New Cases (2008) 2,570 50 Chlamydia: Rates per 100,000 Population (2007) 232.4 45 Diabetes: 2005-2007 3 Yr Average (95% CI) 6.6% (+/- 0.5) 42 Human West Nile Virus: New Cases (2008) 8 28 Hypertension: 2003-2007 3 Yr Average (95% CI) 25.2% (+/- 0.8) 41 Obesity: 2005-2007 3 Yr Average (95 % CI) 24.0% (+/- 0.8) 33 Syphilis: Rates per 100,000 Population (2007) 0.8 41 Tobacco: Current Smokers 2005-2007 3 Yr Average (95% CI) 21.7% (+/- 0.9) 18 Tuberculosis: Number of Cases (2007) 2 51 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Level of Adult Physical Inactivity; Most AIDS Cases; Most Alzheimer’s Cases; Highest Rates of Asthma; Most New Cases of Cancer; Highest Rates of Chlamydia; Highest Rate of Diabetes; Most Cases of West Nile Virus; Highest Rates of Hypertension; Highest Rates of Obesity; Highest Rates of Syphilis; Highest Rates of Current Smokers; Most Cases of Tuberculosis. Child/Adolescent Health Indicators AIDS: Cumulative Cases Under Aged 13 (2006) 2 49 Asthma: High School Students (2007) 23.1% (+/- 2.1) N/A Immunization Gap: Children Aged 19-35 Months without All Immunizations (2007) 29.8% 7 Infant Mortality: Per 1,000 Live Births (2005) 6.8 27 Low Birthweight: % of Total Births (2006) 8.9% 14 Obesity Rates, % High School Students (2007) 9.3% (+/-1.5) N/A Obesity Rates, % Children Age 10-17 (2004) 8.7% 50 Pre-Term Labor: % of Live Births (2006) 12.8% 24 Tobacco: Current Smokers High School Students (2007) N/A N/A *Note: For rankings, 1 = Worst Health Outcome. 1 = Most AIDS Cases; Highest Rates of Asthma; Highest Rates of Not-Fully-Immunized Babies; Most Cases of Infant Mortality; Highest Rate of Low Birth Weight Babies; Highest Rates of Overweight High School Students; Highest Rates of Overweight 10-17 Year Olds; Highest Rates of Pre-Term Labor Babies; Highest Rates of Current High School Smokers. Other Public Health Indicators Health Professions Shortage Areas - Primary Care (FY 2008) 38 44 Health Professions Shortage Areas - Mental Health (FY 2008) 22 43 Health Professions Shortage Areas - Dental Care (FY 2008) 20 45 Nursing Shortage Estimates (2010) -1,200 38 *Note: For rankings, 1 = Worst Health Outcome. 1 = Highest Number of Primary Care HPSAs; Highest Number of Mental Health HPSAs; Highest Number of Dental Care HPSAs; Largest Nursing Shortage Estimate Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pandemic 4,000 49 Potential # of Episodes of Illness During a Severe Pandemic 150,000 51 Potential Financial Loss During a Severe Pandemic, % of GDP 6.40% 4 Potential Financial Loss During a Severe Pandemic, $ amount $1.7 Billion N/A *Note: For rankings, 1 = Worst Outcome. 1 = Highest Number of Potential Deaths; Highest Number of Potential Sick Workers; Highest Financial Losses. 123 THE STATE OF YOUR HEALTH: WYOMING Public Health Funding Facts Federal Funding for Wyoming’s Public Health Per Capita Funding State Rank* U.S. Centers for Disease Control (CDC) FY 2008 $32.43 3 Health Resources and Services Administration (HRSA) FY 2008 $20.55 20 Office of the Assistant Secretary for Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) FY 2008 $2.15 1 *Note: For rankings, 1= Most Funding. 1 = Highest Level of CDC Funding Per Capita; Highest Level of HRSA Funding Per Capita; Highest ASPR Funding Per Capita. FY 2008 CDC Funds for State/Local Health Departments, Universities & Other Public/Private Agencies (Selected Categories) Agency for Toxic Substances and Disease Registry (ATSDR) $0 Birth Defects and Developmental Disabilities $148,986 Cancer $1,584,405 Chronic Disease Prevention and Health Promotion $408,807 Diabetes $291,735 Environmental Health $0 Heart Disease $0 HIV/AIDS $1,078,160 Immunization (Sect. 317 and Vaccines for Children Program) $6,231,981 Infectious Diseases $779,395 Injury and Violence Prevention $69,363 Nutrition and Physical Activity $0 Occupational Safety and Health $0 Pandemic Flu $136,028 Preventive Health and Health Services Block Grant $219,409 School Health $175,000 Sexually Transmitted Diseases (STD) $225,608 Tobacco $854,999 Terrorism Preparedness and Emergency Response $4,878,976 Tuberculosis $191,122 Total FY 2008 CDC Dollars (All Categories) $17,273,974 FY 2008 HRSA Grants to State by Key Program Area (Selected Categories) Health Professions $1,146,382 HIV/AIDS $923,938 Maternal & Child Health $1,883,497 Primary Health Care $4,506,608 Total FY 2008 HRSA Dollars (All Categories) $10,742,939 FY 2008 Office of the Assistant Secretary for Preparedness and Response Grants to States Hospital Preparedness Program (HPP) $1,124,115 Total FY 2008 ASPR HPP Dollars $1,124,115 State Spending State Per Capita Funding for Wyoming’s Health: $64.19 State Per Capita Funding Ranking:10 *Note: For rankings, 1= Most Funding. 1 = Highest State Funding for Public Health. *Note: The FY 2008 CDC dollars do not include contractual amounts that were included in the FY 2007 Shortchanging America’s Health report. The change in the methodology reflects the public health impact of CDC dollars in each state, but does not allow for an accurate comparison of dollars from FY 2007 to FY 2008. 124 Appendix A: NOTES ON DATA AND METHODOLOGY T he sources for the funds and indicators come from a variety of publicly available sources. In some cases fiscal years for funding may vary depending on availability of data, and year of health indicators may vary slightly as well. Funding References CDC Funds for State and Local Health Depart- ASPR Per Capita Total FY 2008 calculated by ments, Universities, & Other Public and Private TFAH by dividing ASPR Totals by July 1, 2008 Agencies FY 2008 data were all provided by the U.S. Census Bureau population estimates. U.S. Centers for Disease Control and Preven- ASPR Per Capita Ranking based on TFAH tion’s Financial Management Office. The total calculated per capita totals. (all categories) was also provided by the CDC; it includes program areas not highlighted here. State Public Health Budget Methodology TFAH conducted an analysis of state spend- CDC Per Capita Total FY 2008 calculated by ing on public health for the last budget cycle, TFAH by dividing CDC Total dollars by July 1, fiscal year 2007-2008. For those states that 2008 U.S. Census Bureau population estimates. only report their budgets in biennium cycles, CDC Per Capita Ranking based on TFAH cal- the 2007-2009 period (or the 2008-2010 and culated per capita totals. 2009-2010 for Virginia and Wyoming respec- tively) was used, and the percent change was HRSA Health Professions, HIV/AIDS, Ma- calculated from the last biennium, 2005-2007 ternal & Child Health, and Primary Health (or 2006-2008 and 2007-2008 for Virginia Care FY 2008 funding data come from HRSA’s and Wyoming respectively). Geospatial Data Warehouse, State Profile Re- port. http://datawarehouse.hrsa.gov (ac- This analysis was conducted from August to cessed September, 2008.) The total HRSA October of 2008 using publicly available dollar amount also came from this source. budget documents through state government HRSA key program area totals, however, were web sites. Based on what was made publicly calculated by TFAH using Microsoft Excel. available, budget documents used included either executive budget document that listed HRSA Per Capita Total FY 2008 calculated by actual expenditures, estimated expenditures, TFAH by dividing HRSA Total dollars by July 1, or final appropriations; appropriations bills 2008 U.S. Census Bureau population estimates. enacted by the state’s legislature; or docu- HRSA Per Capita Ranking based on TFAH ments from legislative analysis offices. calculated per capita totals. “Public health” is defined to broadly include all ASPR Hospital Preparedness Program FY health spending with the exception of Medi- 2008 funding data from U.S. Department of caid, CHIP, or comparable health coverage Health and Human Services, “HHS Provides programs for low-income residents. Federal More Than $1 Billion to Improve All Hazards funds, mental health funds, addiction or sub- Public Health,” June 3, 2008, News Release. stance abuse-related funds, WIC funds, services http://www.hhs.gov/news/press/2008 related to developmental disabilities or severely pres/06/20080603a.html (accessed Decem- disabled persons, and state-sponsored phar- ber 11, 2008). maceutical programs also were not included in 125 order to make the state-by-state comparison Because each state allocates and reports its more accurate since many states receive federal budget in a unique way, comparisons across money for these particular programs. In a few states are difficult. This methodology may in- cases, state budget documents did not allow clude programs that, in come cases, the state these programs, or other similar human serv- may consider a public health function, but ices, to be disaggregated; these exceptions are the methodology used was selected to maxi- noted. For most states, all state funding, re- mize the ability to be consistent across states. gardless of general revenue or other state funds As a result, there may be programs or items (e.g. dedicated revenue, fee revenue, etc.), was states may wish to be considered “public used. In some cases, only general revenue health” that may not be included in order to funds were used in order to separate out fed- maintain the comparative value of the data. eral funds; these exceptions are also noted. Population Facts U.S. Total Population estimates come from Health Insurance Coverage Status by State the U.S. Census Bureau, National and State for All People: 2007.” http://pubdb3.cen- Population Estimates, “Annual Estimates of sus.gov/macro/032008/health/h06_000.ht the Population for the United States, Regions, m (accessed December 11, 2008). States, and Puerto Rico: April 1, 2000 to July 1, Total Number of Uninsured, 18 and under 2008,” released December 22, 2008 and avail- estimates come from the U.S. Census Bu- able online at http://www.census.gov/ reau. “Current Population Survey, Table popest/states/NST-ann-est.html (accessed HI05: Health Insurance Coverage Status and January 5, 2009). Type of Coverage by State and Age for All Total Number of U.S. Uninsured, All Ages es- People: 2007.” http://pubdb3.census.gov/ timates come from the U.S. Census Bureau, macro/032008/health/h05_000.htm (ac- “Current Population Survey, Table HI06. cessed December 11, 2008). Population FactsAdult Health Indicator References **Note: All Behavioral Risk Factor Surveillance System (BRFSS) statistics use 3 years of com- bined data to “stabilize” yearly figures. TFAH contracted with Daniel Eisenberg, PhD, Assis- tant Professor, and Edward Okeke, MBBS, Health Service Organization and Policy Doctoral Student, both with the Department of Health Management and Policy, at the University of Michigan School of Public Health to carry out this data analysis. Adult Physical Inactivity Rate 2005-2007 3 Yr ics/surveillance/resources/reports/2006re- Average data come from the BRFSS Preva- port/pdf/2006SurveillanceReport.pdf (ac- lence Data 2005-2007, percent responding cessed December 11, 2008). “did not engage in any physical activity”. Na- Alzheimer’s Estimated Cases among 65+ tional Center for Chronic Disease Prevention (2010) data come from the Alzheimer’s Asso- & Health Promotion, Centers for Disease ciation report “Alzheimer’s Disease Facts and Control and Prevention. Available at Figures 2008.” http://www.alz.org/na- http://apps.nccd.cdc.gov/brfss/index.asp tional/documents/report_alzfactsfigures2008. AIDS Cumulative Cases Aged 13 and Older pdf (accessed December 11, 2008). The 2006 Yr End data come from Table 14, Alzheimer’s Association derived the estimated HIV/AIDS Surveillance Report: Cases of HIV numbers of people age 65+ with Alzheimer’s Infection and AIDS in the United States, 2006, Disease from: L.E. Herbert, et al. “State-spe- National Center for HIV, STD, and TB Pre- cific Projections Through 2025 of Alzheimer vention, CDC. http://www.cdc.gov/hiv/top- Disease Prevalence.” Neurology 62 (2004):1645. 126 Asthma 2005-2007 3 Yr Average data come sion data is collected only on odd-numbered from the BRFSS Prevalence Data 2005-2007, years. To stabilize the data, researchers used percent responding “ever been told” they have combined data from 2003, 2005 and 2007. asthma. National Center for Chronic Disease National Center for Chronic Disease Preven- Prevention & Health Promotion, Centers for tion & Health Promotion, Centers for Dis- Disease Control and Prevention. Available at ease Control and Prevention. Available at http://apps.nccd.cdc.gov/brfss/index.asp http://apps.nccd.cdc.gov/brfss/index.asp Cancer Estimated New Cases 2008 data come Obesity 2005-2007 3 Yr Average data were cal- from the American Cancer Society’s Cancer culated by contractors using self-reported height Facts and Figures 2008. http://www.cancer.org/ and weight measure from the BRFSS Prevalence downloads/STT/2008CAFFfinalsecured.pdf Data 2005-2007. National Center for Chronic (accessed December 11, 2008). Disease Prevention & Health Promotion, Centers for Disease Control and Prevention. Chlamydia Rates per 100,000 Population Available at http://apps.nccd.cdc.gov/brfss/ (2007) data come from the “Sexually Trans- index.asp. Obesity was defined as having a BMI mitted Disease Surveillance, 2007.” Atlanta, greater than or equal to 30. GA: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, Syphilis Rates per 100,000 Population (2007) and TB Prevention, U.S. Centers for Disease data come from the “Sexually Transmitted Dis- Control and Prevention, December 2008. ease Surveillance, 2007.” Atlanta, GA: Division Table 2. Chlamydia - Reported cases and of STD Prevention, National Center for rates by state, ranked by rates: United States, HIV/AIDS, Viral Hepatitis, STD, and TB Pre- 2007. http://www.cdc.gov/std/stats07/ta- vention, U.S. Centers for Disease Control and bles/2.htm (accessed January 14, 2009). Prevention, December 2007. Table 24. Pri- mary and secondary syphilis - Reported cases Diabetes 2005-2007 3 Yr Average data come and rates by state, ranked by rates: United from the BRFSS Prevalence Data 2005-2007, States, 2007. http://www.cdc.gov/std/ percent responding “ever been told” they have stats07/tables/24.htm (accessed January 14, diabetes. National Center for Chronic Disease 2009). Prevention & Health Promotion, Centers for Disease Control and Prevention. Available at Tobacco Use - Current Smokers 2005-2007 3 http://apps.nccd.cdc.gov/brfss/index.asp Yr Average data come from the BRFSS Preva- lence Data 2005-2007, percent responding Human West Nile Virus Cases 2008 data they are current smokers. National Center for come from the U.S. Centers for Disease Con- Chronic Disease Prevention & Health Promo- trol and Prevention, Division of Vector-Borne tion, Centers for Disease Control and Preven- Infectious Diseases, http://www.cdc.gov/nci- tion. Available at http://apps.nccd.cdc.gov/ dod/dvbid/westnile/sur v&controlCaseC- brfss/index.asp. ount08_detailed.htm (accessed December 11, 2008). Tuberculosis (TB) Number of Cases 2007 data come from “Reported Tuberculosis in the Hypertension 2003-2007 3 Yr Average data United States, 2007,” CDC, September 2008. come from the BRFSS Prevalence Data 2003- http://www.cdc.gov/tb/surv/2007/pdf/full- 2007, percent responding “ever been told” report.pdf (accessed December 11, 2008). they have high blood pressure. Hyperten- 127 Adolescent and Child Health Indicators AIDS Cumulative Cases Children Under 13 Low Birthweight Babies 2006 data come from 2006 data come from Table 14, HIV/AIDS “Births: Final Data for 2006, State-specific De- Surveillance Report: Cases of HIV Infection tailed Tables for 2006.” National Vital Statistics and AIDS in the United States, 2006, National Reports; 56(7). National Center for Health Center for HIV, STD, and TB Prevention, Statistics, Hyattsville, Maryland: 2006. Table 36: CDC. http://www.cdc.gov/hiv/topics/sur- Percentage of low birthweight births: United veillance/resources/repor ts/2006re- States and each state and territory, final 2006. port/pdf/2006Sur veillanceReport.pdf http://www.cdc.gov/nchs/data/nvsr/nvsr57/ (accessed December 11, 2008). nvsr57_07.pdf (accessed January 27, 2009). Asthma 2007 High School Students data come Obese High School Students 2007 data come from the Youth Risk Behavior Surveillance from the Youth Risk Behavior Surveillance System, Comprehensive Results 2007, percent System, Comprehensive Results 2005. Na- responding “ever been told” they have tional Center for Chronic Disease Prevention asthma. National Center for Chronic Disease & Health Promotion, Centers for Disease Prevention & Health Promotion, Centers for Control and Prevention. Available at Disease Control and Prevention. Available at: http://www.cdc.gov/HealthyYouth/yrbs/ http://www.cdc.gov/HealthyYouth/yrbs/ind index.htm. ex.htm. (accessed December 11, 2008). Obese 10 to 17 Year Olds 2003 – 2004 data Immunization Gap: Children Aged 19 to 35 come from the National Survey of Children’s Months without all Immunizations 2007 data Health, 2003. Overweight and Physical Activ- come from “Estimated Vaccination Coverage ity among Children: A Portrait of States and with Individual Vaccines and Selected Vacci- the Nation 2005, Health Resources and Serv- nation Series Among Children 19-35 Months ices Administration, Maternal and Child of Age by State and Local Area U.S., National Health Bureau. http://www.mchb.hrsa.gov/ Immunization Survey, Q1/2007-Q4/2007.” overweight/index.htm (accessed January http://www.cchd.org/download/fact_sheets 17, 2008). /nis-07-vaccines-state.pdf (accessed Decem- Pre-Term Births as Percent of Live Births ber 11, 2008). TFAH used the data for the 2006 data comes from “Births: Final Data for 4:3:1:3:3:1 series which is the CDC-recom- 2006”, National Vital Statistics Reports; 57(7). mended series for children aged 19-35 National Center for Health Statistics, Hy- months.42 The 4:3:1:3:3:1 series is used to attsville, Maryland: 2008. Table 34: Number evaluate progress toward one of the Healthy and percentage of births delivered preterm, People 2010 objectives, which aims to by race and Hispanic origin of mother: achieve greater than 80% coverage with the United States, each state and territory, 2006. series among children ages 19-35 months.43 http://www.cdc.gov/nchs/data/nvsr/nvsr57 Infant Mortality per 1,000 Live Births 2005 /nvsr57_07.pdf (accessed January 12, 2009). data come from “Deaths: Final Data for 2005” Tobacco: Current Smokers High School Stu- National Vital Statistics Reports; 56(10). Na- dents 2007 data come from the Youth Risk tional Center for Health Statistics, Hyattsville, Behavior Surveillance System, Comprehen- Maryland: 2008. Table 32: Number of infant sive Results 2005, percent of “students who and neonatal deaths and mortality rates, by smoked cigarettes on one or more of the past race for the United States, each state, Puerto 30 days.” National Center for Chronic Dis- Rico, Virgin Islands, Guam, American Samoa, ease Prevention & Health Promotion, Cen- and Northern Marianas, and by sex for the ters for Disease Control and Prevention. United States, 2005. http://www.cdc.gov/ Available at http://www.cdc.gov/HealthyY- nchs/data/nvsr/nvsr56/nvsr56_10.pdf (ac- outh/yrbs/pdf/yrbss07_mmwr.pdf (accessed cessed February 18, 2009). December 11, 2008). 128 Other Public Health Indicators Health Professions Shortage Areas: Primary Projected Supply vs. Demand for RNs (2010) Care, Mental Health, Dental Care FY 2008 data comes from the National Center for data come from HRSA’s Geospatial Data Health Workforce Analysis in the Bureau of Warehouse, State Profile Report. Health Professions, Health Resources and http://datawarehouse.hrsa.gov (accessed Services Administration paper “What Is Be- December 11, 2008.) hind HRSA’s Projected Supply, Demand and Shortage of Registered Nurses?” Washington, D.C.: September 2004. Pandemic Preparedness Key Facts Potential # of Deaths During a Severe Pan- Flu Aid is limited in its ability to account for demic estimates in each state used the same density issues, such as how close people live to- assumptions of a 30 percent attack rate and a gether in cities versus rural areas. 2.5 percent case-fatality rate. The rates were Potential Financial Loss during a Severe Pan- calculated using the Flu Aid computer mod- demic, % of GDP data comes from: Trust for eling program developed by CDC, which also America’s Health. Pandemic Flu and the Po- considers the age and health risk factors of a tential for U.S. Economic Recession. Wash- state’s population.44 It should be noted that ington, D.C.: Trust for America’s Health, Flu Aid is limited in its ability to account for 2007. Available at: http://healthyameri- density issues, such as how close people live cans.org/reports/flurecession/. together in cities versus rural areas. Potential Financial Loss during a Severe Pan- Potential # of Episodes of Illness During a Se- demic, dollar amount data comes from: Trust vere Pandemic estimates in each state used the for America’s Health. Pandemic Flu and the same assumptions of a 30 percent attack rate Potential for U.S. Economic Recession. Wash- and a 2.5 percent case-fatality rate. The rates ington, D.C.: Trust for America’s Health, were calculated using the Flu Aid computer 2007. Available at: http://healthyameri- modeling program developed by CDC, which cans.org/reports/flurecession/. also considers the age and health risk factors of a state’s population. It should be noted that 129 Appendix B STATE-BY-STATE HEALTH INDICATORS ADULT HEALTH INDICATORS State 2008 Census % Uninsured, Adult Physical AIDS Cumulative Alzheimer’s Asthma Cancer Estimated Population All Ages Inactivity Rate Cases Aged Estimated Cases 2005-2007 New Cases Estimates (2007) 2005-2007 13 and Older among 65+ 3 Yr Average - 2008 3 Yr Average 2006 Yr End (2010) (95% Conf Interval) (95% CI) Alabama 4,661,900 12.0 29.6% (+/- 1.1) 8,626 91,000 12.6% (+/- 0.9) 22,340 Alaska 686,293 18.2 20.9% (+/- 1.4) 648 5,000 13.5% (+/- 1.2) 2,650 Arizona 6,500,180 18.3 22.4% (+/- 1.4) 10,396 97,000 13.6% (+/- 1.1) 25,540 Arkansas 2,855,390 16.1 29.1% (+/- 0.9) 3,891 60,000 11.7% (+/- 0.7) 14,840 California 36,756,666 18.2 23.3% (+-/ 0.9) 142,254 480,000 12.9% (+/- 0.7) 156,530 Colorado 4,939,456 16.4 17.3% (+/- 0.6) 8,742 72,000 12.7% (+/- 0.6) 18,900 Connecticut 3,501,252 9.4 20.2% (+/- 0.8) 14,716 70,000 13.4% (+/- 0.7) 19,190 Delaware 873,092 11.2 22.3% (+/- 1.0) 3,547 14,000 12.9% (+/- 0.9) 4,590 D.C. 591,833 9.5 21.9% (+/- 1.0) 17,372 9,100 15.4% (+/- 0.9) 2,560 Florida 18,328,340 20.2 25.8% (+/- 0.7) 104,084 450,000 11.3% (+/- 0.5) 101,920 Georgia 9,685,744 17.5 25.5% (+/- 0.9) 31,734 120,000 12.2% (+/- 0.7) 36,980 Hawaii 1,288,198 7.5 18.9% (+/- 0.8) 2,927 27,000 14.7% (+/- 0.8) 6,310 Idaho 1,523,816 13.9 20.6% (+/- 0.8) 604 26,000 12.7% (+/- 0.7) 6,430 Illinois 12,901,563 13.4 23.7% (+/- 0.9) 33,620 210,000 12.1% (+/- 0.7) 59,130 Indiana 6,376,792 11.4 25.5% (+/- 0.8) 8,239 120,000 12.9% (+/- 0.7) 29,550 Iowa 3,002,555 9.3 23.0% (+/- 0.8) 1,727 69,000 10.5% (+/- 0.6) 16,150 Kansas 2,802,134 12.7 23.3% (+/- 0.7) 2,781 53,000 11.7% (+/- 0.6) 12,520 Kentucky 4,269,245 13.6 30.7% (+/- 1.0) 4,600 80,000 12.5% (+/- 0.8) 23,270 Louisiana 4,410,796 18.5 31.4% (+/- 1.0) 17,612 83,000 10.5% (+/- 0.7) 23,360 Maine 1,316,456 8.8 21.1% (+/- 0.9) 1,110 25,000 14.7% (+/- 0.8) 8,140 Maryland 5,633,597 13.7 23.0% (+/- 0.8) 30,252 86,000 13.1% (+/- 0.8) 27,380 Massachusetts 6,497,967 5.4 21.8% (+/- 0.6) 19,181 120,000 14.7% (+/- 0.6) 34,470 Michigan 10,003,422 11.6 22.0% (+/- 0.7) 14,941 180,000 14.3% (+/- 0.6) 51,150 Minnesota 5,220,393 8.3 15.7% (+/- 0.9) 4,817 94,000 11.3% (+/- 0.8) 23,160 Mississippi 2,938,618 18.8 31.8% (+/- 0.9) 6,642 53,000 11.2% (+/- 0.7) 13,400 Missouri 5,911,605 12.6 24.7% (+/- 1.1) 11,016 110,000 13.4% (+/- 0.9) 29,390 Montana 967,440 15.6 20.4% (+/- 0.9) 373 21,000 12.7% (+/- 0.7) 5,090 Nebraska 1,783,432 13.2 22.3% (+/- 0.8) 1,479 37,000 11.1% (+/- 0.7) 8,710 Nevada 2,600,167 17.2 26.1% (+/- 1.3) 5,733 29,000 12.7% (+/- 1.0) 11,370 New Hampshire 1,315,809 10.5 20.1% (+/- 0.7) 1,074 22,000 14.9% (+/- 0.7) 7,030 New Jersey 8,682,661 15.8 27.4% (+/- 0.7) 48,750 150,000 12.2% (+/- 0.6) 45,900 New Mexico 1,984,356 22.5 22.5% (+/- 0.8) 2,603 31,000 14.1% (+/- 0.7) 8,260 New York 19,490,297 13.2 25.8% (+/- 0.8) 174,908 320,000 13.6% (+/- 0.7) 97,130 North Carolina 9,222,414 16.4 24.6% (+/- 0.6) 15,954 170,000 11.1% (+/- 0.5) 40,420 North Dakota 641,481 10.0 22.5% (+/- 0.9) 144 18,000 10.9% (+/- 0.8) 3,090 Ohio 11,485,910 11.7 24.8% (+/- 1.0) 14,957 230,000 12.7% (+/- 0.8) 56,840 Oklahoma 3,642,361 17.8 30.0% (+/- 0.8) 4,836 74,000 13.6% (+/- 0.6) 17,860 Oregon 3,790,060 16.8 17.4% (+/- 0.7) 5,995 76,000 15.4% (+/- 0.7) 19,230 Pennsylvania 12,448,279 9.5 24.0% (+/- 0.8) 33,417 280,000 12.5% (+/- 0.6) 70,110 Rhode Island 1,050,788 10.8 24.7% (+/- 1.0) 2,580 24,000 15.3% (+/- 0.9) 6,120 South Carolina 4,479,800 16.4 25.1% (+/- 0.7) 13,301 80,000 11.9% (+/- 0.6) 20,740 South Dakota 804,194 10.1 23.0% (+/- 0.8) 255 19,000 10.5% (+/- 0.6) 4,080 Tennessee 6,214,888 14.4 31.1% (+/- 1.1) 12,457 120,000 11.9% (+/- 0.8) 29,390 Texas 24,326,974 25.2 28.1% (+/- 0.9) 69,735 340,000 12.2% (+/- 0.7) 96,320 Utah 2,736,424 12.8 19.1% (+/- 0.8) 2,295 32,000 13.3% (+/- 0.8) 7,760 Vermont 621,270 11.2 18.5% (+/- 0.7) 461 11,000 14.4% (+/- 0.7) 3,530 Virginia 7,769,089 14.8 21.6% (+/- 0.9) 16,802 130,000 13.7% (+/- 0.9) 35,590 Washington 6,549,224 11.3 17.4% (+/- 0.4) 11,792 110,000 14.6% (+/- 0.4) 32,380 West Virginia 1,814,468 14.1 27.5% (+/- 1.0) 1,500 44,000 12.5% (+/- 0.8) 10,250 Wisconsin 5,627,967 8.2 19.1% (+/- 0.8) 4,513 110,000 12.9% (+/- 0.8) 27,590 Wyoming 532,668 13.6 21.8% (+/- 0.8) 228 10,000 12.8% (+/- 0.7) 2,570 U.S. Total 304,059,724 15.3 N/A* 952,221 4,844,100 N/A* 1,437,180 Notes *BRFSS data is not an accurate source of national-level data. 130 Chlamydia Rates Diabetes Human West Hypertension Obesity Syphilis Rates Tobacco Use - Tuberculosis per 100,000 2005-2007 Nile Virus 2003-2007 2005-2007 per 100,000 Current Smokers Number of Cases Population 3 Yr. Average Cases 2008 3 Yr Average 3 Yr. Average Population 2005-2007 2007 (2007) Percentage (95% CI) Percentage (2007) 3 Yr Average (95% CI) (95% CI) (95% CI) 546.9 10.0% (+/- 0.6) 21 33.5% (+/- 1.0) 30.1% (+/- 1.2) 8.3 23.5% (+/- 1.2) 175 732.9 5.5% (+/- 0.7) 0 23.9% (+/- 1.4) 27.3% (+/- 1.5) 1.0 23.7% (+/- 1.5) 51 403.3 8.1% (+/- 0.8) 109 24.2% (+/- 1.2) 23.3% (+/- 1.5) 4.8 19.4% (+/- 1.4) 304 354.1 8.5% (+/- 0.5) 9 31.5% (+/- 0.9) 28.1% (+/- 0.9) 4.3 23.2% (+/- 0.9) 106 389.3 7.6% (+/- 0.5) 411 27.2% (+/- 0.9) 23.1% (+/- 0.9) 5.6 14.8% (+/- 0.8) 2726 361.6 5.1% (+/- 0.3) 95 21.7% (+/- 0.7) 18.4% (+/- 0.7) 1.2 18.8% (+/- 0.7) 111 326.8 6.8% (+/- 0.4) 8 25.7% (+/- 0.8) 20.8% (+/- 0.8) 1.1 16.3% (+/- 0.7) 108 407.6 8.4% (+/- 0.6) 1 29.2% (+/- 1.1) 25.9% (+/- 1.2) 2.1 20.4% (+/- 1.1) 19 1036.7 7.7% (+/- 0.6) 0 27.9% (+/- 1.2) 22.1% (+/- 1.0) 30.6 18.4% (+/- 1.0) 60 318.3 8.7% (+/- 0.4) 2 29.3% (+/- 0.9) 23.3% (+/- 0.7) 5.0 20.6% (+/- 0.7) 989 458.3 9.2% (+/- 0.5) 8 29.4% (+/- 0.8) 27.5% (+/- 0.9) 7.3 20.4% (+/- 0.9) 474 440.2 7.7% (+/- 0.5) 0 26.1% (+/- 0.9) 20.7% (+/- 0.8) 0.7 17.2% (+/- 0.8) 122 253.8 7.2% (+/- 0.5) 33 25.4% (+/- 0.9) 24.6% (+/- 0.9) 0.1 18.0% (+/- 0.9) 9 432.3 8.3% (+/- 0.5) 19 26.7% (+/- 0.9) 25.3% (+/- 0.9) 3.6 20.2% (+/- 0.9) 521 328.1 8.3% (+/- 0.5) 3 28.1% (+/-0.8) 27.5% (+/- 0.9) 0.9 25.1% (+/- 0.9) 128 289.8 7.0% (+/- 0.5) 10 26.3% (+/- 0.8) 26.3% (+/- 0.9) 0.7 20.6% (+/- 0.9) 43 295.9 7.2% (+/- 0.4) 38 25.6% (+/- 0.7) 25.8% (+/- 0.7) 1.0 18.6% (+/- 0.7) 59 209.2 9.6% (+/- 0.6) 3 30.1% (+/- 0.9) 28.4% (+/- 1.0) 1.3 28.5% (+/- 1.0) 120 451.6 9.5% (+/- 0.5) 36 30.9% (+/- 1.0) 29.5% (+/- 1.0) 12.4 22.9% (+/- 0.9) 218 192.3 7.4% (+/- 0.5) 0 27.6% (+/- 1.0) 23.7% (+/- 0.9) 0.7 20.6% (+/- 0.9) 19 412.2 7.8% (+/- 0.4) 14 27.7% (+/- 0.8) 25.2% (+/- 0.8) 6.1 17.9% (+/- 0.7) 270 250.8 6.7% (+/- 0.3) 0 25.8% (+/- 0.6) 20.9% (+/- 0.6) 2.4 17.4% (+/- 0.6) 224 370.0 8.6% (+/- 0.4) 17 28.7% (+/- 0.8) 27.7% (+/- 0.8) 1.2 21.8% (+/- 0.8) 226 259.6 5.7% (+/- 0.5) 21 22.6% (+/- 0.9) 24.8% (+/- 1.0) 1.1 18.3% (+/- 1.0) 238 745.1 10.6% (+/- 0.5) 99 34.5% (+/- 0.9) 31.7% (+/- 1.0) 4.6 24.2% (+/- 0.9) 137 398.9 7.7% (+/- 0.5) 19 29.1% (+/- 1.1) 27.4% (+/- 1.1) 4.1 23.7% (+/- 1.1) 119 290.9 6.2% (+/- 0.4) 5 24.5% (+/- 0.9) 21.7% (+/- 0.8) 0.8 19.2% (+/- 0.8) 11 290.2 7.3% (+/- 0.4) 49 25.5% (+/- 0.8) 26.5% (+/- 0.9) 0.2 19.9% (+/- 0.9) 25 381.2 7.6% (+/- 0.7) 16 26.0% (+/- 1.2) 23.6% (+/- 1.3) 4.4 22.2% (+/- 1.2) 102 156.3 7.0% (+/- 0.4) 0 24.9% (+/- 0.8) 23.6% (+/- 0.8) 2.3 19.5% (+/- 0.8) 11 246.8 8.1% (+/- 0.4) 7 27.2% (+/- 0.7) 22.9% (+/- 0.7) 2.6 17.7% (+/- 0.7) 467 484.0 7.5% (+/- 0.5) 9 24.0% (+/- 0.8) 23.3% (+/- 0.9) 2.4 20.8% (+/- 0.8) 51 418.1 8.0% (+/- 0.5) 44 27.0% (+/- 0.8) 23.5% (+/- 0.8) 5.5 19.2% (+/- 0.8) 1175 345.6 8.9% (+/- 0.3) 0 29.8% (+/- 0.7) 27.1% (+/- 0.6) 3.6 22.5% (+/- 0.6) 345 281.3 6.5% (+/- 0.5) 43 25.1% (+/- 0.9) 25.9% (+/- 1.0) 0.2 20.2% (+/- 0.9) 7 413.3 8.0% (+/- 0.5) 20 28.2% (+/- 0.9) 26.9% (+/- 1.1) 1.7 22.6% (+/- 1.0) 252 350.0 9.7% (+/- 0.5) 7 30.7% (+/- 0.7) 28.1% (+/-0.8) 1.8 25.3% (+/- 0.8) 149 266.1 6.8% (+/- 0.4) 16 25.5% (+/- 0.8) 25.0% (+/- 0.8) 0.5 18.0% (+/- 0.8) 94 341.4 8.4% (+/- 0.5) 14 28.2% (+/- 0.8) 25.7% (+/- 1.2) 2.1 22.0% (+/- 0.8) 276 297.6 7.0% (+/- 0.5) 1 29.2% (+/- 1.0) 21.4% (+/- 1.0) 3.4 18.7% (+/- 1.0) 45 611.7 9.8% (+/- 0.5) 0 31.3% (+/- 0.7) 29.2% (+/- 0.8) 2.1 22.2% (+/- 0.7) 218 335.1 6.5% (+/- 0.4) 39 25.8% (+/- 0.7) 26.1% (+/- 0.9) 0.9 20.0% (+/- 0.8) 13 444.9 10.6% (+/- 0.7) 17 32.1% (+/- 1.1) 29.0% (+/- 1.2) 6.1 24.5% (+/- 1.1) 234 364.9 8.8% (+/- 0.5) 62 26.9% (+/- 0.7) 27.2% (+/- 0.9) 4.9 19.1% (+/- 0.8) 1510 224.3 5.7% (+/- 0.4) 26 20.3% (+/- 0.8) 21.8% (+/- 0.9) 0.8 11.0% (+/- 0.7) 39 169.4 6.3% (+/- 0.4) 0 24.6% (+/- 0.8) 21.1% (+/- 0.7) 1.6 18.3% (+/- 0.7) 3 321.6 7.4% (+/- 0.5) 1 27.3% (+/- 1.0) 25.2% (+/- 1.1) 3.0 19.5% (+/- 1.0) 309 293.7 6.8% (+/- 0.3) 2 25.4% (+/- 0.4) 24.5% (+/- 0.5) 2.4 17.1% (+/- 0.5) 291 174.2 11.1% (+/- 0.6) 1 33.2% (+/- 1.0) 30.6% (+/- 1.1) 0.3 26.4% (+/- 1.0) 24 351.9 6.4% (+/- 0.4) 7 25.9% (+/- 0.9) 25.5% (+/- 1.0) 1.2 20.4% (+/- 0.9) 70 232.4 6.6% (+/- 0.5) 8 25.2% (+/- 0.8) 24.0% (+/- 0.8) 0.8 21.7% (+/- 0.9) 2 370.2 N/A* 1370 N/A* N/A* 3.8 N/A* 13,299 131 Appendix C STATE-BY-STATE HEALTH INDICATORS CHILD State 2008 Census % Uninsured, AIDS Asthma - 2007 Immunization Gap, Population 18 and under Cumulative High School % of Children Aged Estimates (2007) Cases Students 19 to 35 Months Under Age 13 - (95% CI) Without All 2006 Yr End Immunizations - 2007 (95% CI) Alabama 4,661,900 7.3 76 N/A 21.8% Alaska 686,293 11.4 7 18.2% (+/- 2.0) 29.9% Arizona 6,500,180 13.8 46 23.0% (+/- 2.1) 24.8% Arkansas 2,855,390 6.2 36 21.1% (+/- 3.3) 27.7% California 36,756,666 10.7 664 N/A 22.9% Colorado 4,939,456 13.0 31 N/A 22.0% Connecticut 3,501,252 5.2 183 27.4% (+/- 2.5) 13.2% Delaware 873,092 7.5 26 N/A 19.7% D.C. 591,833 6.2 189 26.1 (+/- 2.6) 18.4% Florida 18,328,340 19.2 1530 19.6% (+/- 1.4) 19.7% Georgia 9,685,744 11.5 231 22.1% (+/- 2.1) 20.4% Hawaii 1,288,198 4.8 17 28.7% (+/- 3.4) 12.5% Idaho 1,523,816 11.0 2 18.5% (+/- 2.6) 34.4% Illinois 12,901,563 6.6 282 20.0% (+/- 2.2) 26.5% Indiana 6,376,792 5.2 56 22.5% (+/- 3.0) 26.0% Iowa 3,002,555 4.8 13 15.4% (+/- 2.6) 24.1% Kansas 2,802,134 7.7 14 20.1% (+/- 2.5) 24.0% Kentucky 4,269,245 8.0 32 26.1% (+/- 1.6) 21.8% Louisiana 4,410,796 12.5 128 N/A 23.0% Maine 1,316,456 5.1 8 25.8% (+/- 3.2) 27.1% Maryland 5,633,597 10.5 319 23.7% (+/- 3.5) 8.7% Massachusetts 6,497,967 3.0 214 N/A 22.1% Michigan 10,003,422 6.2 113 23.5% (+/- 2.0) 21.2% Minnesota 5,220,393 6.4 28 N/A 19.5% Mississippi 2,938,618 12.1 56 17.2% (+/- 2.0) 22.9% Missouri 5,911,605 10.4 61 20.8% (+/- 2.6) 23.9% Montana 967,440 12.6 3 20.9% (+/- 1.7) 34.7% Nebraska 1,783,432 10.0 11 N/A 17.1% Nevada 2,600,167 14.3 29 N/A 36.9% New Hampshire 1,315,809 6.5 10 N/A 9.4% New Jersey 8,682,661 12.9 778 N/A 19.5% New Mexico 1,984,356 15.5 7 24.9% (+/- 3.0) 24.0% New York 19,490,297 8.9 2354 23.9% (+/- 1.8) 22.2% North Carolina 9,222,414 12.1 118 20.3% (+/- 2.4) 22.7% North Dakota 641,481 7.9 1 19.4% (+/- 2.0) 22.8% Ohio 11,485,910 8.6 138 21.3% (+/- 1.7) 22.3% Oklahoma 3,642,361 12.6 26 20.0% (+/- 1.8) 21.5% Oregon 3,790,060 10.6 20 N/A 29.5% Pennsylvania 12,448,279 7.4 365 N/A 21.2% Rhode Island 1,050,788 8.8 28 25.8% (+/- 1.8) 25.0% South Carolina 4,479,800 14.2 105 22.5% (+/- 2.3) 20.5% South Dakota 804,194 8.0 5 16.1% (+/- 2.6) 23.1% Tennessee 6,214,888 9.1 59 20.2% (+/- 2.1) 21.3% Texas 24,326,974 21.4 392 19.7% (+/- 2.4) 22.7% Utah 2,736,424 10.4 20 22.7% (+/- 4.6) 26.4% Vermont 621,270 9.4 6 N/A 32.7% Virginia 7,769,089 10.2 177 N/A 24.5% Washington 6,549,224 6.8 34 N/A 31.0% West Virginia 1,814,468 4.6 11 24.6% (+/- 3.3) 24.5% Wisconsin 5,627,967 5.8 33 21.5% (+/- 1.9) 22.9% Wyoming 532,668 9.6 2 23.1% (+/- 2.1) 29.8% U.S. Total 304,059,724 11.0 9,094 20.3 (+/- 1.1) 22.6% 132 AND ADOLESCENT HEALTH INDICATORS Infant Mortality - Low Birthweight Obesity - 2007 Obesity: Pre-Term Births Tobacco – 2007: 2005 Babies - 2006 High School % of 10 to 17 % of live births % of Current Per 1,000 Students (95% CI) Year Olds 2006 Tobacco Use among Live Births (2003-2004) High School Students (95% CI) 9.4 10.5% N/A 16.7% 17.1 N/A 5.9 6.0% 16.2% (+/- 2.7) 11.1% 11.2 24.1% (+/- 2.5) 6.9 7.1% 14.2% (+/- 2.3) 12.2% 13.2 N/A 7.9 9.2% 15.8% (+/- 2.3) 16.4% 13.7 28.3% (+/- 3.6) 5.3 6.8% N/A 13.2% 10.7 N/A 6.4 8.9% N/A 9.9% 12.2 N/A 5.8 8.1% 13.3% (+/- 1.9) 12.3% 10.4 N/A 9.0 9.3% 17.5% (+/- 1.7) 14.8% 13.7 24.6% (+/- 2.0) 14.0 11.5% 17.8% (+/- 2.1) 22.8% 16.0 12.8 (+/- 2.1) 7.2 8.7% 15.2% (+/- 1.3) 14.4% 13.8 20.2% (+/- 1.6) 8.2 9.6% 18.2% (+/- 2.1) 16.4% 14.1 26.2% (+/- 2.3) 6.5 8.1% 14.3% (+/- 2.7) 13.3% 12.1 N/A 6.1 6.9% 11.7% (+/- 2.6) 10.1% 11.6 26.1% (+/- 4.1) 7.4 8.6% 15.7% (+/- 2.0) 15.8% 13.3 25.3% (+/- 3.3) 8.0 8.2% 15.3% (+/- 1.8) 15.6% 13.2 29.3% (+/- 4.8) 5.3 6.9% 13.5% (+/- 2.2) 12.5% 11.6 25.5% (+/- 3.9) 7.4 7.2% 14.4% (+/- 2.2) 14.0% 11.8 25.2% (+/- 2.0) 6.6 9.1% 16.4% (+/- 1.6) 20.6% 15.1 33.6% (+/- 2.8) 10.1 11.3% N/A 17.2% 16.4 N/A 6.9 6.8% 13.1% (+/- 2.4) 12.7% 11.1 21.3% (+/- 3.4) 7.3 9.4% 15.2% (+/- 2.8) 13.3% 13.5 20.4% (+/- 4.6) 5.2 7.9% 14.6% (+/- 2.0) 13.6% 11.3 24.4% (+/- 3.1) 7.9 8.3% 16.5% (+/- 2.0) 14.5% 12.5 24.8% (+/- 3.9) 5.1 6.5% N/A 10.1% 10.5 N/A 11.4 12.4% 17.9% (+/- 1.9) 17.8% 18.8 25.6% (+/- 3.0) 7.5 8.1% 14.3% (+/- 1.5) 15.6% 12.8 29.6% (+/- 6.1) 7.0 7.3% 13.3% (+/- 1.3) 11.1% 11.9 30.0% (+/- 2.9) 5.6 7.1% N/A 11.9% 12.5 N/A 5.8 8.3% 14.5% (+/- 1.9) 12.4% 14.4 N/A 5.3 6.9% 14.4% (+/-2.0) 12.9% 10.4 26.6% (+/- 3.0) 5.2 8.6% N/A 13.7% 12.9 N/A 6.1 8.9% 13.5% (+/- 2.1) 16.8% 14.1 30.2% (+/- 4.0) 5.8 8.3% 16.3% (+/- 1.3) 15.3% 12.4 17.7% (+/- 2.0) 8.8 9.1% 17.1% (+/- 1.9) 19.3% 13.6 N/A 6.0 6.7% 13.7% (+/- 3.3) 12.1% 12.1 27.4% (+/- 3.2) 8.3 8.8% 15.0% (+/-3.3) 14.2% 13.3 N/A 8.1 8.3% 15.2% (+/- 1.9) 15.4% 13.9 31.3% (+/- 4.0) 5.9 6.1% N/A 14.1% 10.3 N/A 7.3 8.4% N/A 13.3% 11.8 N/A 6.5 8.0% 16.2% (+/- 1.8) 11.9% 12.6 21.6% (+/- 4.5) 9.4 10.1% 17.1% (+/- 2.3) 18.9% 15.4 24.2% (+/- 3.9) 7.2 7.0% 14.5% (+/- 2.1) 12.1% 12.7 N/A 8.9 9.6% 18.1% (+/- 2.1) 20.0% 14.8 32.8% (+/- 4.2) 6.6 8.4% 15.6% (+/- 2.0) 19.1% 13.7 26.8% (+/- 3.0) 4.5 6.9% 11.7% (+/- 2.5) 8.5% 11.5 8.9% (+/- 3.4) 6.7 6.9% 14.5% (+/- 2.8) 11.3% 9.6 N/A 7.5 8.3% N/A 13.8% 12.0 N/A 5.1 6.5% N/A 10.8% 11.0 N/A 8.1 9.7% 17.0% (+/- 3.2) 20.9% 14.0 34.5% (+/- 4.4) 6.6 6.9% 14.0% (+/- 1.4) 13.5% 11.4 27.5% (+/- 2.0) 6.8 8.9% 11.4% (+/- 1.4) 8.7% 12.8 N/A 6.9 8.3% 13.0% (+/- 1.1) 14.8% 12.8 25.7% (+/- 3.0) 133 Appendix D STATE-BY-STATE HEALTH INDICATORS OTHER PUBLIC HEALTH INDICATORS State 2008 Census Health Professions Health Professions Health Professions Nursing Population Service Areas Service Areas Service Areas Shortage Estimates Primary Care Mental Health Dental Care Estimates (As of 09/15/08) (As of 09/15/08) (As of 09/15/08) (2010) Alabama 4,661,900 86 48 62 -200 Alaska 686,293 71 52 45 -2,300 Arizona 6,500,180 139 48 78 -12,500 Arkansas 2,855,390 88 38 37 -2,700 California 36,756,666 522 261 286 -47,600 Colorado 4,939,456 109 34 71 -10,900 Connecticut 3,501,252 41 19 40 -11,100 Delaware 873,092 12 6 8 -1,300 D.C. 591,833 14 8 8 -3,000 Florida 18,328,340 241 132 200 -32,700 Georgia 9,685,744 186 61 135 -16,400 Hawaii 1,288,198 31 28 27 -4,500 Idaho 1,523,816 67 24 60 -800 Illinois 12,901,563 266 117 167 -9,300 Indiana 6,376,792 97 45 38 -8,200 Iowa 3,002,555 90 35 100 -3,400 Kansas 2,802,134 144 44 114 -1,000 Kentucky 4,269,245 136 78 57 1,200 Louisiana 4,410,796 120 62 80 100 Maine 1,316,456 75 30 60 -2,500 Maryland 5,633,597 47 31 38 -7,000 Massachusetts 6,497,967 69 48 66 -16,100 Michigan 10,003,422 202 89 122 -3,100 Minnesota 5,220,393 118 46 67 -4,400 Mississippi 2,938,618 109 41 102 -500 Missouri 5,911,605 181 52 132 -12,900 Montana 967,440 92 50 57 -500 Nebraska 1,783,432 75 19 32 -2,400 Nevada 2,600,167 55 18 20 -4,100 New Hampshire 1,315,809 25 16 20 -3,300 New Jersey 8,682,661 35 28 30 -19,600 New Mexico 1,984,356 91 43 63 -3,100 New York 19,490,297 175 126 104 -21,500 North Carolina 9,222,414 116 53 103 -8,100 North Dakota 641,481 76 42 27 -900 Ohio 11,485,910 116 55 91 -12,100 Oklahoma 3,642,361 198 89 88 -500 Oregon 3,790,060 100 48 71 -5,300 Pennsylvania 12,448,279 174 86 134 -21,100 Rhode Island 1,050,788 20 17 17 -3,000 South Carolina 4,479,800 88 42 66 -5,200 South Dakota 804,194 91 44 50 -200 Tennessee 6,214,888 120 48 126 -18,500 Texas 24,326,974 407 272 218 -41,900 Utah 2,736,424 59 31 47 -1,500 Vermont 621,270 25 15 16 -600 Virginia 7,769,089 117 73 90 -11,000 Washington 6,549,224 144 103 103 -8,800 West Virginia 1,814,468 98 53 65 700 Wisconsin 5,627,967 110 104 72 500 Wyoming 532,668 38 22 20 -1,200 U.S. Total 304,059,724 5,906 2,974 3,930 -405,800 134 PANDEMIC PREPAREDNESS KEY FACTS Potential # of Potential # of Potential Potential Deaths During Sick During a Financial Loss Financial Loss a Severe Severe During a During a Pandemic Pandemic Severe Pandemic, Severe Pandemic, % of GDP $ amount 37,000 1,350,000 5.45% $8.3 Billion 4,000 192,000 6.59% $2.6 Billion 38,000 1,766,000 5.52% $12.0 Billion 22,000 823,000 5.81% $5.0 Billion 253,000 10,713,000 5.36% $86.9 Billion 30,000 1,381,000 5.40% $11.7 Billion 29,000 1,039,000 5.23% $10.1 Billion 6,000 250,000 5.32% $3.0 Billion 5,000 162,000 4.62% $3.8 Billion 149,000 5,254,000 5.74% $38.7 Billion 57,000 2,688,000 5.46% $19.8 Billion 10,000 365,000 6.60% $3.6 Billion 9,000 425,000 5.42% $2.6 Billion 99,000 3,787,000 5.60% $31.3 Billion 49,000 1,863,000 5.87% $14.0 Billion 26,000 878,000 5.90% $6.7 Billion 22,000 810,000 5.58% $5.9 Billion 33,000 1,232,000 5.87% $8.2 Billion 35,000 1,339,000 6.03% $10.1 Billion 11,000 391,000 5.38% $2.4 Billion 41,000 1,656,000 5.09% $12.5 Billion 55,000 1,895,000 5.20% $16.9 Billion 82,000 3,003,000 5.39% $20.3 Billion 39,000 1,526,000 5.44% $12.8 Billion 22,000 864,000 5.99% $4.9 Billion 47,000 1,717,000 5.74% $12.4 Billion 7,000 277,000 5.86% $1.8 Billion 14,000 520,000 6.22% $4.4 Billion 13,000 720,000 8.08% $9.0 Billion 10,000 389,000 5.30% $2.9 Billion 71,000 2,585,000 5.42% $23.4 Billion 13,000 571,000 5.42% $3.7 Billion 157,000 5,706,000 5.20% $49.8 Billion 62,000 2,556,000 5.48% $19.0 Billion 6,000 186,000 5.71% $1.4 Billion 96,000 3,396,000 5.54% $24.4 Billion 28,000 1,046,000 5.55% $6.7 Billion 28,000 1,082,000 5.46% $7.9 Billion 113,000 3,675,000 5.50% $26.9 Billion 9,000 318,000 5.29% $2.3 Billion 31,000 1,256,000 5.62% $ 7.9 Billion 6,000 229,000 5.71% $1.8 Billion 45,000 1,767,000 5.98% $13.7 Billion 146,000 6,789,000 5.57% $55.1 Billion 14,000 737,000 5.49% $5.0 Billion 5,000 185,000 5.65% $1.3 Billion 54,000 2,208,000 5.13% $18.1 Billion 45,000 1,853,000 5.36% $14.3 Billion 17,000 537,000 5.69% $3.0 Billion 44,000 1,643,000 5.56% $12.0 Billion 4,000 150,000 6.40% $1.7 Billion 2,250,000 87,750,000 5.51% $683 Billion 135 Appendix E STATE-BY-STATE FUNDING CHART -- FY 2008 CDC Funds for State/Local Health Departments State Agency for Birth Defects Cancer Chronic Diabetes Environmental Heart HIV/AIDS Immunization Infectious Injury & Toxic and Disease Health Disease (Section 317 & Diseases Violence Substances Developmental Prevention/ Vaccines for Prevention and Disease Disabilities Health Children) Registry Promotion (ATSDR) Alabama $0 $515,954 $5,035,823 $4,427,710 $380,359 $299,040 $382,768 $3,527,760 $41,879,755 $1,087,129 $1,606,504 Alaska $236,955 $537,064 $7,809,526 $2,511,166 $787,633 $115,735 $1,380,199 $1,905,969 $12,876,780 $706,280 $716,303 Arizona $343,189 $1,115,833 $4,505,230 $1,140,390 $256,270 $119,820 $325,000 $6,078,747 $77,254,777 $1,095,819 $1,029,715 Arkansas $201,277 $1,172,622 $3,771,644 $557,524 $407,679 $0 $1,233,033 $2,233,043 $30,720,952 $717,915 $597,905 California $758.388 $3,945,927 $12,194,408 $11,247,574 $3,130,243 $4,912,994 $464,714 $61,636,140 $348,481,638 $8,380,559 $10,667,174 Colorado $220,269 $2,818,588 $5,611,192 $2,257,353 $1,232,097 $530,355 $465,231 $9,364,506 $39,164,962 $3,258,711 $2,651,679 Connecticut $415,765 $183,320 $2,581,172 $1,825,888 $698,159 $2,267,657 $358,925 $7,926,823 $29,441,813 $3,501,839 $1,015,488 Delaware $0 $200,000 $1,672,974 $209,249 $434,003 $247,133 $0 $2,384,623 $8,382,092 $550,184 $938,404 D.C. $1,088,316 $9,653,026 $3,282,298 $10,907,190 $2,099,093 $4,900,987 $1,040,684 $21,320,023 $9,630,009 $3,865,932 $1,443,710 Florida $545,503 $1,330,963 $6,716,018 $2,789,582 $666,596 $2,352,837 $1,055,703 $34,550,088 $140,853,876 $1,368,230 $2,493,462 Georgia $1,084,020 $1,106,356 $8,079,543 $12,938,355 $1,096,787 $2,663,059 $4,234,672 $14,392,413 $87,766,437 $4,079,836 $2,704,239 Hawaii $0 $278,673 $2,275,167 $1,701,355 $1,369,038 $440,000 $330,113 $2,657,394 $12,345,405 $569,840 $1,278,224 Idaho $183,331 $0 $2,279,043 $569,661 $340,881 $334,999 $343,456 $970,580 $18,546,460 $524,151 $177,987 Illinois $813,823 $2,493,057 $9,416,948 $8,452,918 $1,303,845 $2,971,683 $590,711 $19,580,704 $116,560,206 $2,953,879 $3,660,418 Indiana $70,000 $212,200 $2,890,479 $1,072,606 $901,526 $1,334,164 $44,021 $4,132,659 $48,954,614 $675,772 $827,452 Iowa $212,480 $3,118,989 $3,589,614 $698,180 $236,424 $1,494,232 $345,000 $1,951,898 $19,856,622 $971,657 $1,800,086 Kansas $0 $545,000 $3,514,512 $1,113,298 $748,667 $280,994 $537,088 $2,004,116 $19,993,820 $735,234 $901,144 Kentucky $0 $150,882 $3,849,463 $1,135,000 $611,989 $450,085 $340,000 $2,584,182 $34,035,141 $546,977 $1,025,303 Louisiana $383,001 $407,050 $2,376,484 $1,315,403 $105,483 $716,115 $293,628 $11,100,991 $57,255,436 $887,517 $733,017 Maine $0 $150,000 $2,797,335 $748,119 $370,800 $1,552,246 $225,698 $1,839,179 $13,544,083 $555,058 $299,528 Maryland $0 $5,797,840 $6,161,595 $3,591,676 $692,461 $2,723,601 $325,000 $19,099,940 $46,290,154 $3,933,124 $5,387,689 Massachusetts $368,374 $1,924,618 $5,814,289 $7,287,645 $975,965 $3,300,174 $1,759,341 $15,408,293 $59,740,608 $1,959,975 $3,397,499 Michigan $648,495 $2,447,860 $11,353,660 $6,045,180 $1,858,327 $2,660,181 $1,407,809 $11,409,113 $80,062,773 $2,378,272 $1,867,310 Minnesota $525,144 $719,730 $7,242,628 $4,127,482 $971,392 $1,177,005 $1,502,142 $4,233,537 $29,779,163 $4,302,218 $1,355,836 Mississippi $0 $0 $3,470,471 $144,718 $265,062 $812,341 $1,229,246 $5,669,760 $33,944,241 $716,031 $533,290 Missouri $391,873 $1,269,375 $5,689,240 $2,079,021 $471,532 $1,966,339 $1,225,000 $6,084,678 $46,695,107 $1,288,234 $1,137,008 Montana $0 $871,547 $3,009,966 $0 $697,655 $0 $1,098,195 $1,743,227 $7,334,264 $639,097 $264,217 Nebraska $0 $149,529 $5,026,154 $810,871 $314,631 $0 $467,373 $1,445,793 $15,645,208 $1,015,191 $358,751 Nevada $0 $462,830 $3,641,755 $355,000 $348,218 $516,644 $0 $3,612,161 $30,635,333 $801,003 $380,548 New Hampshire $291,357 $628,140 $2,443,537 $0 $391,268 $1,348,002 $77,564 $1,687,326 $9,157,388 $690,080 $759,452 New Jersey $605,070 $6,033,107 $4,271,542 $133,519 $839,126 $2,691,719 $332,114 $24,658,797 $62,868,856 $1,069,147 $1,351,378 New Mexico $22,934 $147,303 $3,581,930 $2,440,299 $476,056 $1,519,372 $44,000 $2,665,881 $37,066,971 $1,484,413 $547,132 New York $915,283 $6,313,803 $11,537,388 $14,033,684 $948,477 $6,108,572 $1,476,889 $85,163,409 $195,627,003 $9,130,929 $5,987,693 North Carolina $175,136 $3,110,212 $7,245,926 $3,481,429 $1,999,046 $1,081,430 $2,115,000 $10,591,240 $109,569,898 $1,162,138 $3,143,141 North Dakota $50,000 $350,000 $2,014,581 $234,408 $273,138 $0 $350,000 $645,311 $5,466,442 $614,873 $300,651 Ohio $519,109 $1,120,847 $5,745,694 $2,769,999 $935,153 $1,770,052 $1,166,522 $7,716,535 $81,979,127 $5,289,121 $3,122,255 Oklahoma $0 $260,000 $4,243,840 $4,258,387 $556,037 $481,250 $749,751 $3,347,476 $40,100,253 $592,380 $1,099,710 Oregon $419,764 $1,129,406 $5,266,140 $1,823,202 $792,792 $2,176,709 $342,102 $4,270,464 $25,634,976 $2,744,414 $2,204,876 Pennsylvania $495,515 $2,298,244 $4,264,271 $3,603,814 $508,883 $3,477,551 $0 $17,898,647 $91,513,229 $2,721,483 $6,646,094 Rhode Island $0 $309,884 $2,309,590 $369,179 $799,263 $1,380,337 $606,633 $2,567,202 $14,734,033 $683,279 $688,136 South Carolina $0 $1,243,330 $5,025,374 $3,899,652 $989,549 $150,000 $1,100,000 $7,765,867 $43,089,987 $793,513 $1,996,408 South Dakota $0 $372,339 $2,467,299 $321,981 $189,569 $0 $0 $827,035 $11,357,597 $720,171 $104,705 Tennessee $162,408 $2,122,000 $2,098,961 $591,465 $143,462 $251,294 $350,000 $6,096,768 $56,949,758 $2,465,003 $1,988,161 Texas $273,805 $2,162,678 $11,128,352 $3,459,124 $1,317,818 $1,508,763 $547,158 $33,877,565 $290,455,138 $2,641,841 $3,445,513 Utah $157,731 $811,569 $3,486,527 $1,628,367 $968,268 $1,215,352 $948,335 $1,281,571 $17,637,574 $1,276,824 $684,230 Vermont $0 $149,757 $2,374,658 $149,588 $272,336 $737,290 $213,896 $1,587,771 $8,974,954 $502,412 $201,641 Virginia $0 $1,103,368 $5,311,174 $2,630,719 $410,742 $1,380,284 $1,010,000 $8,264,939 $44,928,243 $2,391,569 $2,930,250 Washington $641,112 $460,694 $7,823,053 $2,574,411 $1,436,509 $1,481,017 $1,433,887 $6,584,548 $84,682,351 $1,518,678 $2,556,079 West Virginia $51,557 $0 $5,724,740 $1,474,171 $890,052 $399,073 $629,657 $1,693,638 $16,241,906 $601,366 $1,106,200 Wisconsin $574,038 $1,844,432 $4,862,589 $1,997,826 $919,067 $3,577,769 $618,457 $3,791,055 $43,584,637 $1,196,705 $2,952,773 Wyoming $0 $148,986 $1,584,405 $408,807 $291,735 $0 $0 $1,078,160 $6,231,981 $779,395 $69,363 U.S. TOTAL $13,845,022 $75,698,932 $250,470,202 $144,344,145 $40,121,161 $73,876,256 $37,116,715 $514,909,545 $2,815,524,031 $95,135,398 $95,135,731 *Note: D.C. was not included in per capita rankings because it receives different funding levels than the 50 states. 136 Nutrition/ Occupational Pandemic Preventive School Sexually Tobacco Terrorism Tuberculosis CDC Total CDC Per CDC Per Physical Safety & Flu Health & Health Transmitted Preparedness Elimination (All Categories) Capita Capita Activity Health Health Diseases & Emergency Total Ranking Services (STD) Response Block Grant $82,250 $861,238 $858,564 $1,609,081 $223,612 $4,223,298 $0 $10,766,811 $1,078,062 $79,016,361 $16.95 32 $0 $75,000 $161,539 $332,961 $232,651 $427,698 $0 $5,000,000 $407,159 $36,220,618 $52.78 1 $0 $0 $146,711 $1,163,758 $745,000 $1,364,486 $347,402 $14,190,689 $1,172,939 $112,443,149 $17.30 30 $686,621 $0 $326,400 $1,134,831 $702,498 $864,301 $910,357 $7,369,593 $1,172,939 $54,781,134 $19.19 23 $1,089,031 $3,875,622 $1,450,123 $6,730,544 $2,783,511 $13,015,433 $404,970 $73,943,044 1$6,349,046 $585,918,083 $15.94 36 $803,599 $1,470,095 $1,377,824 $1,476,854 $805,607 $2,109,770 $1,093,115 $11,231,353 $528,675 $88,522,335 $17.92 29 $9,000 $478,121 $739,853 $1,402,350 $569,772 $1,068,922 $889,343 $9,415,983 $445,901 $65,236,094 $18.63 28 $0 $0 $122,361 $181,792 $249,158 $545,355 $437,770 $5,000,000 $251,018 $21,806,116 $24.98 9 $1,443,433 $1,918,309 $741,314 $]1,402,350 $4,691,281 $2,885,695 $551,846 $13,654,074 $804,826 $98,964,121 $NA* NA* $0 $1,538,467 $1,411,187 $3,082,934 $1,517,512 $4,062,320 $528,750 $29,669,053 $7,030,192 $243,563,273 $13.29 47 $1,066,687 $450,063 $5,138,480 $3,012,467 $530,619 $3,914,273 $901,944 $21,724,929 $2,445,792 $180,956,083 $18.68 27 $0 $0 $1,546,194 $751,610 $375,427 $366,490 $763,562 $4,997,077 $873,515 $32,919,084 $25.55 8 $0 $0 $97,458 $360,505 $507,489 $394,478 $936,825 $5,214,010 $176,843 $31,958,157 $20.97 18 $0 $1,156,606 $1,624,625 $2,809,162 $625,881 $4,279,316 $972,977 $31,716,374 $2,928,553 $214,962,853 $16.66 33 $485,377 $214,220 $910,119 $1,636,601 $577,845 $1,651,931 $855,124 $13,094,801 $652,709 $81,208,839 $12.74 50 $842,721 $1,800,077 $428,414 $1,301,894 $229,677 $716,072 $833,761 $8,340,941 $391,826 $49,160,565 $16.37 34 $119,787 $387,700 $96,895 $911,765 $257,997 $788,485 $1,026,429 $7,659,039 $397,590 $42,419,311 $15.14 41 $0 $407,497 $124,770 $1,517,216 $372,250 $931,070 $939,064 $9,684,300 $827,262 $59,532,451 $13.94 46 $0 $157,878 $596,852 $2,797,953 $283,883 $1,490,819 $907,923 $10,415,739 $1,296,991 $93,735,053 $21.25 16 $0 $0 $1,594,791 $859,434 $231,948 $252,843 $794,968 $4,976,106 $178,351 $30,970,487 $23.53 11 $0 $5,984,412 $3,329,703 $2,056,786 $639,726 $3,222,706 $993,392 $17,368,515 $1,306,115 $129,116,215 $22.92 12 $1,058,951 $2,973,099 $2,041,071 $2,625,825 $1,172,877 $1,875,495 $1,284,491 $19,416,825 $1,129,386 $135,514,801 $20.85 19 $951,678 $1,631,937 $2,183,202 $3,824,512 $1,018,179 $2,688,126 $1,374,750 $20,767,521 $1,118,599 $157,697,484 $15.76 37 $645,573 $1,048,290 $2,879,084 $2,438,794 $764,009 $989,332 $988,675 $15,000,469 $1,003,719 $81,747,496 $15.66 40 $35,035 $0 $121,720 $1,403,587 $661,882 $1,040,327 $445,576 $7,629,747 $765,440 $58,888,474 $20.04 21 $356,573 $35,614 $216,676 $2,550,206 $222,650 $2,483,080 $953,317 $13,753,474 $565,709 $89,491,706 $15.14 41 $823,955 $107,000 $84,367 $636,129 $208,000 $253,684 $792,875 $4,855,493 $121,789 $23,541,460 $24.33 10 $937,478 $20,486 $1,074,095 $1,597,263 $190,000 $451,318 $1,022,755 $5,848,300 $210,957 $36,639,529 $20.54 20 $0 $0 $34,026 $382,108 $255,699 $748,234 $707,071 $7,721,260 $541,270 $51,143,160 $19.67 22 $380,847 $446,325 $927,091 $1,636,232 $196,777 $238,183 $858,560 $5,302,054 $259,122 $27,719,305 $21.07 17 $815,092 $373,315 $147,372 $2,803,799 $949,689 $2,818,525 $1,050,687 $19,261,216 $3,684,681 $136,758,751 $15.75 38 $0 $101,000 $839,371 $1,491,019 $238,800 $635,659 $940,567 $6,797,290 $363,644 $61,403,641 $30.94 5 $1,690,118 $1,673,487 $2,383,993 $6,676,150 $1,395,000 $8,700,153 $1,544,471 $45,986,506 $9,518,481 $416,872,239 $21.39 14 $1,404,275 $1,243,287 $105,802 $2,944,884 $1,076,359 $2,419,315 $1,378,253 $18,866,091 $1,830,037 $175,248,392 $19.00 25 $0 $0 $296,034 $247,175 $545,000 $264,085 $952,598 $4,837,509 $165,982 $17,607,787 $27.45 7 $0 $791,068 $182,166 $4,194,561 $850,954 $3,525,490 $1,126,657 $22,321,759 $1,123,551 $146,519,336 $12.76 49 $58,727 $157,450 $98,845 $914,484 $408,088 $712,504 $1,093,550 $9,266,029 $784,028 $69,582,765 $19.10 24 $0 $410,438 $1,858,263 $706,960 $256,567 $1,174,832 $901,485 $9,100,217 $690,151 $61,903,758 $16.33 35 $450,000 $1,342,386 $822,764 $4,757,441 $656,831 $4,671,911 $1,062,934 $25,549,169 $1,382,824 $174,123,991 $13.99 45 $821,857 $0 $763,323 $601,499 $444,471 $405,601 $949,656 $4,842,787 $441,409 $33,718,139 $32.09 4 $1,059,557 $66,419 $411,488 $1,194,141 $894,399 $1,316,862 $1,003,690 $10,494,629 $1,233,499 $83,728,364 $18.69 26 $0 $0 $56,905 $226,162 $645,000 $211,686 $793,727 $4,893,439 $234,436 $23,422,051 $29.12 6 $457,522 $175,000 $308,230 $1,580,945 $524,387 $2,280,218 $1,040,809 $11,842,828 $1,531,663 $92,960,882 $14.96 44 $777,346 $889,773 $957,310 $4,237,055 $647,580 $6,157,007 $796,499 $43,211,012 $8,952,835 $417,444,172 $17.16 31 $464,953 $767,057 $404,292 $1,008,736 $0 $481,402 $1,001,838 $8,457,508 $320,170 $43,052,657 $15.73 39 $0 $0 $72,922 $263,811 $194,999 $161,819 $939,747 $4,901,506 $136,520 $21,835,627 $35.15 2 $0 $641,557 $2,415,584 $2,249,425 $2,062,210 $1,817,815 $879,582 $17,773,879 $1,078,659 $100,068,077 $12.88 48 $1,042,746 $2,506,154 $264,378 $1,035,325 $899,622 $3,292,064 $1,163,230 $16,877,379 $1,451,949 $139,782,186 $21.34 15 $642,706 $405,900 $135,459 $980,637 $624,696 $678,572 $965,109 $5,933,288 $336,453 $39,515,180 $21.78 13 $833,805 $248,100 $171,945 $1,896,411 $664,878 $1,093,182 $981,707 $12,060,242 $406,564 $84,276,182 $14.97 43 $0 $0 $136,028 $219,409 $175,000 $225,608 $854,999 $4,878,976 $191,122 $17,273,974 $32.43 3 $22,337,300 $38,830,447 $45,217,983 $93,857,533 $35,997,947 $102,387,850 $44,939,387 $723,880,833 $82,290,953 $5,352,891,948 $17.60 NA* ** The U.S. total includes funds for all 50 states and Washington D.C. 137 Appendix F FY 2008 HRSA Grants to States by Key Program Area (Selected Programs) State Health HIV/AIDS Maternal & Primary HRSA Total HRSA Per HRSA Per Professions Child Health Health (All Programs) Capita Total Capita Care (All Programs) Ranking Alabama $13,159,513 $26,497,698 $17,527,673 $39,896,764 $111,590,471 $24.11 14 Alaska $3,049,732 $1,999,782 $2,516,682 $32,774,777 $48,358,459 $70.75 1 Arizona $4,627,397 $24,056,348 $10,097,477 $37,764,125 $81,532,014 $12.86 44 Arkansas $1,755,751 $9,654,675 $8,921,688 $22,709,090 $49,202,740 $17.36 26 California $23,663,244 $253,545,552 $59,305,732 $200,733,710 $563,425,406 $15.41 35 Colorado $4,904,398 $25,582,440 $11,751,614 $56,669,646 $105,906,655 $21.78 18 Connecticut $1,460,602 $30,835,129 $8,461,097 $21,725,248 $66,167,554 $18.89 24 Delaware $658,196 $6,307,810 $2,798,787 $5,820,990 $17,498,587 $20.24 21 D.C. $3,351,874 $74,843,002 $24,828,041 $11,224,929 $116,323,431 *NA *NA Florida $11,687,847 $210,290,287 $26,478,858 $93,978,530 $357,249,277 $19.57 22 Georgia $7,159,079 $71,988,152 $23,081,280 $44,214,244 $153,462,033 $16.08 33 Hawaii $3,830,117 $3,681,098 $4,998,708 $26,201,503 $41,186,239 $32.09 8 Idaho $761,378 $2,076,203 $3,925,550 $18,072,737 $29,134,290 $19.43 23 Illinois $7,534,874 $76,758,136 $37,431,749 $84,801,725 $221,165,510 $17.21 28 Indiana $3,741,556 $17,714,573 $15,877,859 $22,213,754 $65,480,314 $10.32 49 Iowa $4,085,264 $4,434,558 $8,809,054 $17,902,725 $49,097,111 $16.43 32 Kansas $2,352,127 $4,248,658 $7,034,385 $9,166,608 $27,646,209 $9.96 50 Kentucky $4,239,240 $10,706,646 $14,231,416 $26,484,995 $71,120,810 $16.77 31 Louisiana $6,536,303 $44,083,719 $17,880,295 $28,271,136 $103,663,693 $24.15 13 Maine $1,023,333 $2,437,372 $5,842,473 $12,917,586 $27,135,738 $20.60 19 Maryland $6,647,386 $206,730,531 $20,489,296 $30,970,966 $270,622,176 $48.17 2 Massachusetts $12,980,319 $130,743,929 $26,363,203 $51,968,593 $232,216,634 $36.00 5 Michigan $8,698,437 $29,275,939 $28,563,026 $46,290,907 $122,293,351 $12.14 45 Minnesota $6,016,804 $13,256,517 $12,688,554 $17,460,674 $57,499,590 $11.06 48 Mississippi $4,932,158 $18,129,809 $11,016,866 $40,255,169 $111,881,930 $38.33 3 Missouri $4,281,346 $28,336,772 $18,171,016 $42,507,359 $101,802,743 $17.32 27 Montana $3,194,210 $1,439,188 $3,777,038 $17,558,820 $34,851,298 $36.38 4 Nebraska $2,893,709 $3,067,519 $7,886,799 $7,794,411 $27,316,904 $15.39 36 Nevada $1,992,574 $14,752,655 $3,330,409 $9,569,664 $35,860,118 $13.98 41 New Hampshire $1,379,705 $2,322,509 $4,104,838 $8,457,255 $19,801,741 $15.05 38 New Jersey $8,042,050 $81,551,938 $15,046,892 $34,874,978 $148,152,925 $17.06 29 New Mexico $2,576,643 $5,881,256 $8,634,426 $36,787,193 $65,883,562 $33.44 7 New York $23,732,980 $340,160,953 $54,889,739 $106,041,266 $548,149,085 $28.40 9 North Carolina $10,789,796 $43,122,696 $24,932,000 $51,753,619 $138,140,389 $15.25 37 North Dakota $2,194,797 $343,526 $3,232,934 $4,373,681 $15,087,012 $23.58 16 Ohio $6,235,019 $31,968,930 $28,568,314 $47,287,193 $127,240,045 $11.10 47 Oklahoma $4,030,585 $11,043,190 $10,905,356 $17,466,347 $47,103,686 $13.02 43 Oregon $3,326,532 $12,250,128 $10,507,348 $37,745,017 $68,710,632 $18.34 25 Pennsylvania $12,756,745 $79,996,142 $36,201,957 $51,316,931 $198,609,748 $15.97 34 Rhode Island $1,673,061 $5,765,240 $2,953,614 $11,800,300 $26,025,026 $24.60 11 South Carolina $4,532,803 $35,611,912 $15,301,521 $45,292,976 $105,340,508 $23.90 15 South Dakota $1,053,672 $1,173,798 $4,369,089 $8,623,110 $21,448,721 $26.94 10 Tennessee $15,146,655 $31,782,146 $15,788,258 $36,164,437 $104,890,871 $17.04 30 Texas $15,741,632 $150,053,709 $42,128,869 $114,240,000 $341,164,609 $14.27 39 Utah $1,970,356 $5,284,977 $13,370,474 $13,197,219 $37,100,062 $14.02 40 Vermont $507,945 $1,404,236 $3,373,669 $6,240,081 $14,165,229 $22.80 17 Virginia $5,195,041 $37,478,195 $16,271,836 $39,449,204 $103,240,575 $13.39 42 Washington $8,657,229 $71,672,321 $12,926,982 $54,422,376 $156,787,361 $24.24 12 West Virginia $2,285,093 $3,266,254 $8,408,245 $26,164,036 $62,039,237 $34.24 6 Wisconsin $6,322,762 $13,108,022 $16,270,480 $19,066,590 $63,205,970 $11.28 46 Wyoming $1,146,382 $923,938 $1,883,497 $4,506,608 $10,742,939 $20.55 20 U.S. TOTAL $300,516,251 $2,313,640,713 $794,156,963 $1,853,191,802 $5,723,721,219 $21.43 NA** *D.C. was not included in the per capita rankings because total funding for D.C. includes funds for a number of national organizations. **The U.S. total reflects HRSA grants to all 50 states and D.C. 138 Endnotes 16 U.S. Department of Health and Human Services. 2009 Budget in Brief. 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