Mapping the Funding Gap: Missouri is Analyzing Public Health Resources vs. Community Need
Success StoriesMissouri invests less per person in state public health funding than any other state. Decades of underinvestment has made it difficult for local health departments to consistently deliver the direct-to-community services that Missourians depend on. In this video, Daniel Bogle, Health Policy Director with the Missouri Department of Health and Senior Services, explains how the Public Health Infrastructure Grant (PHIG) is helping Missouri change the status quo. Using PHIG funding, the state launched a Foundational Public Health Services Cost Gap Analysis project to collect data from all 115 local public health agencies across Missouri. This analysis compares current funding and staffing levels with what’s actually needed to deliver effective public health services where people live.
These findings will inform system-level changes that strengthen public health statewide. Even now, the process is helping local agencies better understand their resources, improve their operations, and serve their communities more effectively. Instead of reacting to one disease at a time, Missouri is using PHIG to build a public health system that’s not only ready to respond to emergencies, but also works to create the conditions people need to live their healthiest lives.
Video Transcript
This transcript has been lightly edited for clarity.
What is public health funding like in Missouri?
So the state of Missouri is actually, if you look at all 50 states plus DC, the lowest funded public health state from general revenue when you look at per capita public health spending. The terminology I’ve used is that Missouri underinvests and has a historic disinvestment in public health. That especially affects the local level, where it’s really those local-based services, those local community services, that are face-to-face community services with people, and it’s these services that really make a difference.
How have you been able to use PHIG funding?
The project that I lead using PHIG funding is the Foundational Public Health Services Cost Gap Analysis, which is a project where we have a contractor who is collecting information from all 115 local public health agencies in Missouri. They are taking information about what their current funding looks like, their current staffing, and comparing that to where we believe we need to be to effectively deliver services to all Missourians, directly where they live.
They’re taking that information, that data, synthesizing that, analyzing that, so that we’ll have a report that indicates what that implementation gap is to truly deliver effective public health services where they live.
How will these findings improve services for Missourians?
The hope is, from a statewide perspective, that we can make system-level changes that will then improve services at the local level. But even in the meantime, we can see that local agencies are able to improve their functions and improve the way they use resources to better serve their citizens.
Why is this funding important?
The reason why PHIG is so essential is that, for the history of public health in the United States, it’s often gone from diagnosis to diagnosis, disease to disease, and it’s focused on what happens in the moment. What has really been realized with public health infrastructure efforts is that we have to build a better public health system to address these conditions. It’s having a public health system that can serve everyone the way it needs to, and be ready for those emergency events so the system has the capacity to respond, and to provide better services.
PHIG funding is absolutely going to allow us to save lives because public health is unique in that it affects every human from conception until death. It’s the entire lifespan. If we’re able to improve quality of life and health at the beginning, we’re able to then do that through the entire lifespan, and we ultimately end up with healthier individuals that live longer lives. And that’s what we’re trying to do in public health – just help every person have the best optimal health that they can have.