Public Health:

A Health Status Indicator for Targeting Federal Aid to States

HEHS-97-13: Published: Nov 13, 1996. Publicly Released: Nov 13, 1996.

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William J. Scanlon
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Pursuant to a congressional request, GAO identified measures of the health status of states' populations that could be used to target federal funds, focusing on whether: (1) premature mortality rates and the number of people in poverty would be appropriate measures of and proxies for health status; and (2) other measures might also be used.

GAO found that: (1) premature mortality is the best single proxy for reflecting differences in the health status of states' populations as measured by both the Centers for Disease Control and Prevention's Healthy People 2000 indicators and the ReliaStar Financial Corporation's composite health status index; (2) using premature mortality to distribute federal funding for core public health functions would systematically target federal assistance to states on the basis of their populations' rates of mortality, disease incidence, and risk for mortality and morbidity; (3) a number of other variables, including the proportion of states' populations that are poor or minorities, were also found to be correlated with health status differences, but including these variables along with premature mortality did not significantly enhance GAO's ability to differentiate the health status of state populations; and (4) improving the targeting of funds beyond that obtained using premature mortality alone would require using several additional variables, which would add to the complexity of the allocation formula.

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