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An Ounce of Prevention: What Public Health Means for Michigan

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An Ounce of Prevention: What Public Health Means for Michigan August 2018 | Report 403 102 YEARS OF UNCOMPROMISING POLICY RESEARCH An Ounce of Prevention: What Public Health Means for Michigan 38777 Six Mile Road, Suite 208 | Livonia, MI 48152 | 734.542.8001 115 West Allegan, Suite 480 | Lansing, MI 48933 | 517.485.9444 P.O. Box 1612 | Holland, MI 49422 | 616-294-8359 | crcmich.org BOARD OF DIRECTORS Chair Terence M. Donnelly Aleksandra A. Miziolek Aleksandra A. Miziolek Dickinson Wright PLLC Cooper Standard Vice Chair Randall W. Eberts Paul R. Obermeyer Michael P. McGee W. E. Upjohn Institute Comerica Bank Treasurer Richard A. Favor, Jr. James M. Polehna Laura Appel Deloitte Kelly Services Todd Anderson June Summers Haas Julie Ridenour Blue Cross Blue Shield of Michigan Honigman Miller Schwartz and Cohn LLP Steelcase Foundation Laura Appel Jim Holcomb Camilo Serna Michigan Health & Hospital Association Michigan Chamber of Commerce DTE Energy Beth A. Bialy Marybeth S. Howe Carolee K. Smith Plante Moran, PLLC Wells Fargo Bank Consumers Energy Lawrence N. Bluth Wendy Lewis Jackson Christine Mason Soneral Penske Corporation The Kresge Foundation ITC Holdings Corp. Chase Cantrell Harry Kemp Kathleen Wilbur Building Community Value Lear Corporation Michigan State University Stephan W. Currie Michael P. McGee Michigan Association of Counties Miller, Canfield, Paddock and Stone PLC Daniel Domenicucci Anne Mervenne Ernst & Young LLP Mervenne & Company BOARD OF TRUSTEES Chair David O. Egner Daniel J. Kelly James M. Nicholson Eugene A. Gargaro, Jr. Ralph C. Wilson, Jr. Foundation Deloitte. Retired PVS Chemicals David L. Eisler Mary Kramer Don R. Parfet Terence E. Adderley Ferris State University Crain Communications, Inc. Apjohn Group LLC Kelly Services, Inc. Fritz Erickson William J. Lawrence, III Philip H. Power 42 North Partners LLC Laura Appel Northern Michigan University The Center for Michigan Michigan Health & Hospital Edward C. Levy, Jr. Association Mark T. Gaffney Edw. C. Levy Co. James E. Proppe Teamsters 214 Plante Moran Donald Bachand Daniel T. Lis Saginaw Valley State University Eugene A. Gargaro, Jr. Attorney-At-Law John Rakolta Jr. Manoogian Foundation Walbridge Daniel Little Beth Chappell University of Michigan-Dearborn RediMinds, Inc. Dan Gilmartin Milton W. Rohwer Michigan Municipal League TALENT 2025 Alphonse S. Lucarelli Brian M. Connolly Ernst & Young LLP. Retired Oakwood Healthcare, Inc., Retired Allan D. Gilmour George E. Ross Wayne State University, Emeritus Michael P. McGee Central Michigan University Matthew P. Cullen Miller, Canfield, Paddock Alfred R. Glancy III John M. Schreuder Rock Ventures LLC and Stone PLC Unico Investment Group LLC First National Bank of Michigan Stephen R. D’Arcy Larry Merrill Detroit Medical Center Thomas J. Haas MIchigan Townships Association Amanda Van Dusen Grand Valley State University Miller, Canfield, Paddock Richard DeVore Anne Mervenne and Stone PLC PNC Bank Richard C. Hampson Mervenne & Co. Citizens Bank Theodore J. Vogel Terence M. Donnelly Aleksandra A. Miziolek CMS Energy Corporation, Retired Dickinson Wright PLLC Paul C. Hillegonds Cooper Standard Michigan Health Endowment Fund John M. Dunn Glenn D. Mroz Western Michigan University Marybeth S. Howe Michigan Technological University Wells Fargo Bank Citizens Research Council of Michigan is a tax deductible 501(c)(3) organization An Ounce of Prevention: What Public Health Means for Michigan Contents Summary ........................................................................................................................................................iii Introduction .....................................................................................................................................................1 What is Public Health? ................................................................................................................................... 3 Core Functions of Public Health .................................................................................................................4 Public Health as a Public Good ..................................................................................................................5 Health Equity ..............................................................................................................................................6 The Broad Reach of Public Health .................................................................................................................7 Infectious Diseases ....................................................................................................................................8 Foodborne Illnesses and Food Safety ........................................................................................................8 Environmental Hazards ..............................................................................................................................9 Chronic Disease Burden and the Cost of Health Care .............................................................................10 The Social Determinants of Health ...........................................................................................................10 History of Public Health in Michigan ............................................................................................................. 11 Public Health Investment in Michigan...........................................................................................................14 The Difficulty of Assessing Public Health Funding ...................................................................................14 Michigan’s Public Health Expenditures ....................................................................................................14 Public Health Investment in Michigan Compared to Other States ............................................................16 Reliance on Federal Funding for Public Health ........................................................................................17 Public Health Funding in Other Departments ...........................................................................................18 Michigan Department of Agriculture and Rural Development ........................................................................................................................................18 Michigan Department of Environmental Quality ...................................................................................18 Other Departments ...............................................................................................................................19 Public Health Funding Across State Agencies ......................................................................................19 Social/Political Investment in Promoting Public Health ............................................................................19 The Ongoing Need for Public Health ............................................................................................................21 Health Indicators in Michigan ...................................................................................................................21 Conclusion ....................................................................................................................................................25 Endnotes ......................................................................................................................................................26 Boxes Public Health Advisory Commission .........................................................................................................12 Public Health 3.0 ......................................................................................................................................20 Infrastructure and Public Health ...............................................................................................................24 Charts Chart A Per-Capita State Funding for Public Health, FY2017 .................................................................17 Chart B Public Health Appropriations in Michigan, FY2018 .....................................................................19 Chart 1 Proportion of Added Average Life Expectancy Attributable to Public Health Efforts in the Year 2000 ............................................................................................................................4 Chart 2 State Expenditures for Public Health, FY2017 ...........................................................................15 Chart 3 Essential Local Public Health Services Expenditures, FY2003 - FY2017 ..................................15 Chart 4 State Public Health Expenditures by Area, FY2013-2017 ..........................................................16 Chart 5 Total Public Health Expenditures, FY2003-2017 ........................................................................16 Chart 6 Per-Capita State Funding for Public Health, FY2017 .................................................................17 Chart 7 Appropriations for Public Health Functions in the Michigan Department of Agriculture and Rural Development,FY 2014-2018 ......................................................................................18 Chart 8 Appropriations for the Michigan Department of Environmental Quality, FY2014-2018 ..............18 Chart 9 Public Health Appropriations in Michigan, FY2018 .....................................................................19 Figures Figure 1 Core Functions of Public
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