TY - JOUR
T1 - Impact of State Public Health Spending on Disease Incidence in the United States from 1980 to 2009
AU - Verma, Reetu
AU - Clark, Samantha
AU - Leider, Jonathon
AU - Bishai, David
N1 - Publisher Copyright:
© Health Research and Educational Trust
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objective: To understand the relationship between state-level spending by public health departments and the incidence of three vaccine preventable diseases (VPDs): mumps, pertussis, and rubella in the United States from 1980 to 2009. Data Sources: This study uses state-level public health spending data from The Census Bureau and annual mumps, pertussis, and rubella incidence counts from the University of Pittsburgh's project Tycho. Study Design: Ordinary least squares (OLS), fixed effects, and random effects regression models were tested, with results indicating that a fixed effects model would be most appropriate model for this analysis. Principal Findings: Model output suggests a statistically significant, negative relationship between public health spending and mumps and rubella incidence. Lagging outcome variables indicate that public health spending actually has the greatest impact on VPD incidence in subsequent years, rather than the year in which the spending occurred. Results were robust to models with lagged spending variables, national time trends, and state time trends, as well as models with and without Medicaid and hospital spending. Conclusion: Our analysis indicates that there is evidence of a significant, negative relationship between a state's public health spending and the incidence of two VPDs, mumps and rubella, in the United States.
AB - Objective: To understand the relationship between state-level spending by public health departments and the incidence of three vaccine preventable diseases (VPDs): mumps, pertussis, and rubella in the United States from 1980 to 2009. Data Sources: This study uses state-level public health spending data from The Census Bureau and annual mumps, pertussis, and rubella incidence counts from the University of Pittsburgh's project Tycho. Study Design: Ordinary least squares (OLS), fixed effects, and random effects regression models were tested, with results indicating that a fixed effects model would be most appropriate model for this analysis. Principal Findings: Model output suggests a statistically significant, negative relationship between public health spending and mumps and rubella incidence. Lagging outcome variables indicate that public health spending actually has the greatest impact on VPD incidence in subsequent years, rather than the year in which the spending occurred. Results were robust to models with lagged spending variables, national time trends, and state time trends, as well as models with and without Medicaid and hospital spending. Conclusion: Our analysis indicates that there is evidence of a significant, negative relationship between a state's public health spending and the incidence of two VPDs, mumps and rubella, in the United States.
KW - CHIP
KW - Tycho
KW - vaccination
KW - vaccine preventable diseases
KW - VFC
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U2 - 10.1111/1475-6773.12480
DO - 10.1111/1475-6773.12480
M3 - Article
C2 - 26997351
AN - SCOPUS:85010654094
SN - 0017-9124
VL - 52
SP - 176
EP - 190
JO - Health services research
JF - Health services research
IS - 1
ER -