Public Health Funding Trends and Implications for States: Inside the ASTHO Profile With RWJF's Carolyn Miller

May 07, 2018|3:58 p.m.| ASTHO Staff

Carolyn E. Miller, MSHP, MACarolyn E. Miller, MSHP, MA, is a senior program officer at the Robert Wood Johnson Foundation (RWJF), which co-funds the ASTHO Profile Survey of State and Territorial Public Health. Prior to joining RWJF, Miller held research positions with Mathematica Policy Research, the Gallup Organization, and Princeton Survey Research Associates International. Her research has spanned a range of issues including health and healthcare, public policy, public opinion, and survey research methodology. With this in mind, ASTHO spoke with Miller to discuss the ASTHO Profile report and its role in public and population health.

Why does RWJF support the ASTHO Profile report?

For over a decade, RWJF has supported the ASTHO Profile report and the NACCHO National Profile report. The ASTHO Profile report is a foundational source of information for both public health officials and researchers about the state of public health in the United States. The Profile helps us at RWJF better understand how changes to public health funding affect the work of state health agencies (SHAs) and allows us to track larger trends. It helps us make connections between funding and health, and it helps public health leaders on the ground compare their agency to counterparts in other regions.

What insights did you find the most interesting from the latest report?

Through the ASTHO Profile report, we learned that 90 percent of state health agencies collaborate across sectors with local public health departments, hospitals, and other partners in healthcare delivery. There has also been a notable increase in the number of agencies that are exchanging information with health insurers.

Understanding these trends helps us at RWJF evaluate the impact that policies and technologies, such as the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Affordable Care Act, and All-Payer Claims Databases, have on the day-to-day activities of public health agencies. Ultimately, the Profile report helps us see that cross-sector collaboration can make the important work of SHAs stronger.

How does the report support RWJF’s vision of a Culture of Health?

First and foremost, the ASTHO Profile makes data accessible to the public, and is useful to individuals beyond public health researchers. It helps everyone, including people on the ground at SHAs. SHA employees can use the data to evaluate where they land compared to similar states, compare priorities, and learn best practices.

Public health researchers can also use the data to track trends in public health and better understand how funding changes impact outcomes and priorities. For example, the report outlines how public health accreditation stimulated quality and performance improvement opportunities, collaboration, and the culture of quality improvement. It also shows that SHAs are performing fewer environmental health activities, as well as fewer poison control or vector control activities, likely due to funding cuts. By understanding the impact of these interventions, policymakers and funders can make informed decisions.

How else does RWJF support public health research?

RWJF encourages partnerships with SHAs and supports utilizing research to evaluate best practices and interventions. Our Systems for Action program funds research that aims to discover and apply new evidence about ways that systems—such as SHAs, hospitals, criminal justice, education, housing and social services—can align to improve the accessibility, quality, and efficiency in the financing and delivery of health and healthcare.

We highlight and fund a variety of public and community health projects to better understand how community-driven solutions impact public health on local levels. From a national to local level, RWJF is helping to strengthen and align systems around the common goal of better health for all.