Michigan State University

Public health spending lags in Michigan, and we have the poor outcomes to show for it

Jon Harrison

"The right to criticize government is also an 

obligation to know what you are talking about."

Lent Upson, first director of the Citizens Research Counci



Public health spending lags in Michigan, and we have the poor outcomes to show for it


A new Citizens Research Council report looks at how spending on prevention, mitigation and education has slipped, pushing the state close to the bottom in per-capita public health expenditures


Download it here






Contact: Nancy Derringer, nderringer@crcmich.org, 734-548-0033


What we found:


  • Public health is a central and yet broadly misunderstood function of government that focuses on prevention of disease and injury and management of environmental factors (physical and social) that affect health. Medicine improves the health of one individual at a time; public health improves the health of entire communities.
  • In recent years, the state has invested little more than what was needed to draw down federal public health funding. This leaves the state heavily reliant on diminishing federal funds. This disinvestment has affected the ability of state and local health departments to provide essential services. Michigan lags the nation in both per capita funding for public health and measures of population health.
  • Improvement may be needed for Michigan’s system of public health service delivery, fragmented between multiple state departments. A “health in all policies” approach should be adopted statewide so that every government policy (from schools to roads to criminal justice) includes assessment of associated health risks and/or benefits. State and local health departments should coordinate public health across sectors and elevate the public’s understanding of public health.


In recent years, Michigan has seen a worst-in-the-nation outbreak of Hepatitis A, numerous outbreaks of vaccine-preventable diseases, an infant mortality rate well above the national average, and above average prevalence of many chronic diseases. And the Flint water crisis, which exposed thousands of young children to a potent neurotoxin, was international news and is costing the state millions to mitigate. In the wake of Flint, dozens of municipalities have higher concentrations of lead in their water supplies, and PFAS, dioxane, and algal blooms continue to threaten water safety throughout the Great Lakes State.


This steady drumbeat of bad health news can be explained in part by the fact that Michigan’s per-capita spending on public-health initiatives is among the lowest in the nation, a new Citizens Research Council of Michigan report finds. The report, An Ounce of Prevention: What Public Health Means for Michigan, is available at crcmich.org.


The failure to invest in public health puts Michigan at greater risk for health-related problems.


“As we have seen with Michigan’s failure to invest in infrastructure, there are consequences to these policy choices,” said said Eric Lupher, President of the Citizens Research Council. "In very real terms, the state’s indifference to this vital role of state and local government is affecting the health of people throughout the state.”


Join us for a webinar to discuss this paper


August 28, 2018 at 11:00 AM EDT.


Register now!


Through a number of budget constraints and a lack of focus on the importance of attention to the issue, Michigan has chronically underfunded public health. This webinar will review our new paper that looks at the role public health plays in assessing threats to well-being, developing policy responses, and assuring the public that their health is being protected.


After registering, you will receive a confirmation email containing information about joining the webinar.


View System Requirements


As outlined above, the Research Council found that the state as a whole has disinvested in state-level public health, as well as funding for essential services provided by local health departments, instead relying heavily on diminishing federal funds. The report highlights that Michigan ranked 43rd in the U.S. (including the District of Columbia) in per-capita funding for public health last year, and has ranked near the bottom in previous years as well.


The research also found that improvement may be needed for Michigan’s system of public health service delivery, which is is fragmented between multiple state departments and local jurisdictions.


A “health in all policies” approach could be adopted statewide to ensure that every government policy (from schools to roads to criminal justice) assesses the health risks and/or benefits associated with a given government action. The state could also take an active role to coordinate public health functions across sectors by working with private and not-for-profit entities, as well as community-based organizations. The state could also do a better job elevating the public’s understanding of public health and related issues.


“The contradictions in priorities are striking,” Lupher said. “While the state has been engaged in a very successful Pure Michigan campaign to promote the state as a place to live, work, and play, its neglect of public health services creates negative press that often washes out the benefits of the promotional campaign. It detracts from the state’s investments in workforce development and job training. And it inflates the healthcare costs that are high to begin with.” 


Research Council president Eric Lupher is available to discuss the report and its implications with news media. Contact Eric directly at 734-542-8001, or Nancy Derringer nderringer@crcmich.org, 734-548-0033, to arrange an interview.




Founded in 1916, the Citizens Research Council of Michigan works to improve government in Michigan. The organization provides factual, unbiased, independent information concerning significant issues of state and local government organization, policy, and finance. By delivery of this information to policymakers and citizens, CRC aims to ensure sound and rational public policy formation in Michigan. For more information, visit www.crcmich.org.



Citizens Research Council of Michigan

 Livonia 734.542.8001 | Lansing 517.485.9444 | Holland 616.294.8359  

crcmich@crcmich.org | crcmich.org


Let's be friends. Find us on your social networks.


Subscribe to Comments for "Public health spending lags in Michigan, and we have the poor outcomes to show for it"