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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.142422v1 AJPH.2008.142422v2 99/10/1780    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Kinner, K. Articles by Pellegrini, C. PubMed PubMed Citation Articles by Kinner, K. Articles by Pellegrini, C. Related Collections Other Health Financing Health Law Health Policy Government

Kyle Kinner, JD, MPA and Cindy Pellegrini, BA

Kyle Kinner is with the Policy and Advocacy Unit, CARE, Washington, DC. Cindy Pellegrini is with the Department of Federal Affairs, the American Academy of Pediatrics, Washington, DC.

Correspondence: Correspondence should be sent to Cindy Pellegrini, 601 13th Street NW, Suite 400, Washington, DC 20005 (e-mail: inquires{at}phsrev.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

We integrated publicly available fiscal and budgetary data to assess historical and prospective trends in public health system funding at the federal, state, and local levels in relation to the recommended objectives outlined in the Institute of Medicine's definitive 2002 report. Although historical growth rates for public health expenditures at all levels were competitive with other major funding objects (requested or funded budget items), outlays for health care services and medical research dwarfed public health spending in absolute amounts. Competition for scarce discretionary resources, competing policy priorities, and protracted fiscal pressures will make it difficult for public health systems to achieve the recommended objectives.