The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.

<h4>Objectives</h4>This study examined the association between state-level public health funding per capita and the odds of poor physical health.<h4>Study design</h4>Cross-sectional.<h4>Methods</h4>Data from the 2018 Behavioral Risk Factor Surveillance System (BRF...

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Main Authors: Stephen Hunter, Sze Y Liu, Daniel M Cook, Kia L Davis, Brendan T Smith, Roman Pabayo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0320920
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author Stephen Hunter
Sze Y Liu
Daniel M Cook
Kia L Davis
Brendan T Smith
Roman Pabayo
author_facet Stephen Hunter
Sze Y Liu
Daniel M Cook
Kia L Davis
Brendan T Smith
Roman Pabayo
author_sort Stephen Hunter
collection DOAJ
description <h4>Objectives</h4>This study examined the association between state-level public health funding per capita and the odds of poor physical health.<h4>Study design</h4>Cross-sectional.<h4>Methods</h4>Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) were used. Participants' self-reported physical health was reported using the CDC Healthy Days Core Module. State-level public health funding per capita was obtained from the State Health Access Data Assistance Center website. Multilevel logistic regression was used to adjust for self-reported individual-level characteristics and state-level characteristics from the 2018 American Community Survey. We also tested whether household income or education attainment moderated any observed associations.<h4>Results</h4>A one SD increase in state-level public health funding per capita was not associated with the odds ≥  14 days of poor physical health (OR = 0.96, 95% CI: 0.90, 1.01). However, heterogeneity across household income was observed. Greater public health funding per capita was associated with lower predicted probabilities of reporting ≥  14 days of poor physical health among respondents from low household income backgrounds ( <$35,000 USD) compared to participants with high household incomes (>$75,000 USD). No associations were observed among those with moderate ($35,000 - $70,000 USD) household incomes. A similar finding was observed among participants with less than high school education when compared to participants with post-secondary education.<h4>Conclusion</h4>Greater state-level public health funding per capita appears to have a protective association against reporting ≥  14 days of poor physical health in individuals with lower household incomes and may be helpful in reducing health inequities. Future research is needed to determine whether this association is causal.
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spelling doaj-art-97f39ee88da94d0abb47d307fbe5244e2025-08-20T03:51:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01204e032092010.1371/journal.pone.0320920The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.Stephen HunterSze Y LiuDaniel M CookKia L DavisBrendan T SmithRoman Pabayo<h4>Objectives</h4>This study examined the association between state-level public health funding per capita and the odds of poor physical health.<h4>Study design</h4>Cross-sectional.<h4>Methods</h4>Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) were used. Participants' self-reported physical health was reported using the CDC Healthy Days Core Module. State-level public health funding per capita was obtained from the State Health Access Data Assistance Center website. Multilevel logistic regression was used to adjust for self-reported individual-level characteristics and state-level characteristics from the 2018 American Community Survey. We also tested whether household income or education attainment moderated any observed associations.<h4>Results</h4>A one SD increase in state-level public health funding per capita was not associated with the odds ≥  14 days of poor physical health (OR = 0.96, 95% CI: 0.90, 1.01). However, heterogeneity across household income was observed. Greater public health funding per capita was associated with lower predicted probabilities of reporting ≥  14 days of poor physical health among respondents from low household income backgrounds ( <$35,000 USD) compared to participants with high household incomes (>$75,000 USD). No associations were observed among those with moderate ($35,000 - $70,000 USD) household incomes. A similar finding was observed among participants with less than high school education when compared to participants with post-secondary education.<h4>Conclusion</h4>Greater state-level public health funding per capita appears to have a protective association against reporting ≥  14 days of poor physical health in individuals with lower household incomes and may be helpful in reducing health inequities. Future research is needed to determine whether this association is causal.https://doi.org/10.1371/journal.pone.0320920
spellingShingle Stephen Hunter
Sze Y Liu
Daniel M Cook
Kia L Davis
Brendan T Smith
Roman Pabayo
The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.
PLoS ONE
title The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.
title_full The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.
title_fullStr The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.
title_full_unstemmed The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.
title_short The cross-sectional association between state-level public health funding per capita and physical health among adults in the United States.
title_sort cross sectional association between state level public health funding per capita and physical health among adults in the united states
url https://doi.org/10.1371/journal.pone.0320920
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