The distribution of health authority health promotion and education expenditure in England: A preliminary assessment

Abstract

This paper asks whether the distribution of district health authority spending on health promotion and education in England is ‘where it should be’. This is aided by simple graphical and statistical analysis using an under-utilised dataset, the Health Service Indicators, which contains information on expenditure by District Health Authorities.It is found that health promotion and education spending varies tremendously across District Health Authorities in England. In order to judge whether this may be justified it is analysed in relation to district-level indicators of ‘need’ as proxied by various measures including standardised mortality ratios for premature ischaemic heart disease, acute myocardial infarction, cerebrovascular disease, suicides, childhood mortality and a deprivation index.Much of the variation seems unexplained, and if confirmed, raises serious questions for policy-makers over how best to ensure that the distribution of such expenditure is more appropriate in future.