Abstract
Despite numerous public health advancements over the last century, we continue to under-invest in prevention and public health efforts. As a result, one of the most challenging aspects of public health is prioritizing the use of limited resources. Building on the foundation of previous researchers, the goal of this exploratory study was to provide current estimates for the actual causes of death, media attention, policy focus, and research funding in the United States. In addition, we sought to calculate and compare media attention, policy attention, and research funding trends to better assess the nation's prioritization of health issues. Using a systematic approach, we searched available databases, including Media Cloud, Nexis Uni, Congress.gov, and the Department of Health and Human Services Tracking Accountability in Government Grants System from January 1, 2010-December 31, 2019 and compared how the actual causes of death in the United States align with health-related media attention, policy attention, and federal spending. Overall, our findings suggest that our priorities are not well-aligned with the actual causes of death. Certain actual causes appear to be consistently misaligned across media, legislative, and financial sectors (e.g., tobacco). This work highlights the importance of multiple strategies—media coverage, national legislation, and government spending—as indicators of public health attention and priorities. These results may inform discussions about how to best allocate U.S. public health resources to better align with the actual causes of death.
Highlights
Over the last century, public health has contributed to drastic reductions in mortality and morbidity
MeSH terms with similar meanings were added to ensure a more inclusive search; see Supplementary Table 1 for a complete list of terms. These search terms were applied to the following databases: the Institute for Health Metrics and Evaluation (IHME) [34], Media Cloud [35], Nexis Uni [36], Congress.gov [24], and the Department of Health and Human Services (HHS) Tracking Accountability in Government Grants System (TAGGS) [37]
We looked at the totals for causes of death, media attention, legislation, and government spending over time; the goal was to assess patterns and provide descriptive information
Summary
Public health has contributed to drastic reductions in mortality and morbidity. In spite of these advancements, we continue to under-invest in prevention and public health efforts [1]. In 2018, the United States spent $3.6 trillion dollars on healthcare, ∼18% of the country’s gross domestic product [2]. In 2018, this equated to an average of $10,874 per person in treatment costs, compared to only $286 per person in prevention efforts [6]. Underinvestment in prevention and limited resources often require decision makers to place priority on some efforts over others. One way to determine priority is the simple quantification of the problem.
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