The Impact of Public Health Spending on California STD Rates

Estimating the Association Between Public Health Spending and Sexually Transmitted Disease Rates in the United States: A Systematic Review

“…8,10,13,15,16 All studies were published in the United States, and the publication years ranged from 2002 to 2019. All included studies 8,10,13,15,16 reported a significant association between increased public health spending and reduced STD rates. Data used for measuring STD rates were mostly obtained from CDC's STD surveillance reports, with one study 13 using data from the California Department of Public Health and another study 16 using data from US Department of Health and Human Services.…”

“…Our review included studies examining both general public health spending and STD-specific public health spending. Of 5 studies, 3 studies 8,10,15 used federal public health spending for specific STD prevention and elimination activities, and 2 studies 13,16 used general public health spending (e.g., per-capita general public health spending within a county and per-capita health care spending in the United States). We organized the results by (1) public health spending and general STD measures, (2) unit of analysis, (3) analytical approach, and (4) the association between public health spending and the rates of specific STDs (e.g., gonorrhea, syphilis, chlamydia, and chancroid).…”

“…As a unit of analysis, 3 studies 8,10,15 analyzed data at the state level. One study by Gallet 13 used annual county-level data; in this case, it was to examine the influence of public health spending on gonorrhea and syphilis rates in California. Another study by Gallet 16 used annual national-level data in the United States from 1960 to 1997.…”

Methods for Sexually Transmitted Disease Prevention Programs to Estimate the Health and Medical Cost Impact of Changes in Their Budget

“…Several published studies have provided evidence that the amount of resources allocated for the prevention of sexually transmitted diseases (STDs) does indeed have an effect on the incidence of STDs at the population level. 1-6 For example, an analysis of state-level gonorrhea case rates and federal funding for STD and HIV prevention from 1981 to 1998 indicated that higher levels of prevention spending in a given year were associated with lower reported rates of gonorrhea in subsequent years. 1 Because the estimated direct medical cost of STDs (including HIV) in the United States is almost $20 billion annually, 7 reductions in the incidence of STDs can yield substantial health and financial benefits.…”

The Estimated Impact of Implementing a Funding Allocation Formula on the Number of Gonorrhea Cases in the United States, 2014 to 2018

“…We focused on gonorrhea cases as the outcome measure because the documented link between STD prevention funding in a given year and lower reported STD rates in subsequent years is much more robust for gonorrhea than for chlamydia and syphilis. 8,10,11,13 In addition to estimating the impact of the funding formula as it was actually implemented, we explored what the impact of the funding formula might have been had it been implemented without restrictions (e.g., without a gradual phase-in or without caps on losses from 1 year to the next). This analysis is particularly important in the era of increasing STD rates and decreasing funding for STD prevention activities.…”