Some things that just seem obvious are often denied for devious political or personal reasons. It just seems obvious, for example, that the more money the government spends on public health projects, the healthier people would become. Conversely, the more public health funds are cut, the less healthy people would likely be.

The recent talk about cutting Medicare and rolling back federal, state and local funding on public health (to fight the deficit) seems to really be saying that the government should not care if its citizens are healthy or sick – each individual is on his or her own. Cut back proponents, of course, claim that the cuts won’t really make such a big difference: There will still be emergency rooms and private charity available. But they know better.

Let’s take this argument out of the realm of politics and right-wing dogma and see what objective scientific evidence is available. I am happy to report that what seems intuitive, common sense is also what scientists report to be objectively true. A report has just come out in the journal Health Affairs that provides clear evidence that the more that is spent on public health, the healthier the population becomes.

The study, summarized in Science Daily, concentrated on four public health concerns: infant mortality, heart disease, diabetes and cancer and correlated variations in spending over a 13 year period on public health by the nearly 3,000 local public health agencies in the U.S. It was found that mortality rates caused by these four health conditions dropped anywhere from 1 percent to nearly 7 percent for each 10 percent of increased public health spending.

Glen P. Mays of the University of Kentucky, one of two authors of the study (along with Sharla A. Smith of the University of Arkansas) was quoted as saying, “In light of the Affordable Care Act that authorized the largest expansion in federal public health spending in decades, coupled with an economic downturn that has precipitated large cuts in state and local government support for public health activities, it’s critical to take a data-driven look at whether public health spending translates to improved health of our population. Our findings suggest that a connection between spending and health outcomes does exist, although it’s important to note that resources must be successfully aimed at activities that target at-risk population groups to ensure that spending is resulting in positive outcomes.”

We should note, therefore, that almost every cut in public health funding affects the four major groups of illness studied and translates into a higher death rate, especially in poorer areas, for real individual people, not just statistical entities. The right wingers, who complain about President Obama’s imaginary “death panels,” should be called on the real death panels they run when they push through spending cuts in public health funding. Moderate Democrats should also think twice about inflicting higher death rates rather than higher tax rates.


Thomas Riggins
Thomas Riggins

Thomas Riggins is associate editor of Political Affairs. Reach him at