Public Health, Politics, and Money: Lessons from Kentucky and Indiana

Public health funding is often discussed as a matter of budgets and policy. But the real story is about politics, relationships and power. In the aftermath of the COVID-19 pandemic, states across the country received an unprecedented influx of federal dollars to strengthen their public health systems. But turning those investments into lasting change proved far more complicated than simply appropriating money.  In this episode, Michael trades places with guest host Rebecca Sale to discuss his ongoing research tracking public health funding in five states. Focusing on Kentucky and Indiana, Michael explains how coalitions of public health leaders, legislators, local officials and community partners helped secure major new investments in local health departments. He also explores why Kentucky's reforms have largely endured while Indiana's funding was dramatically reduced, and what these contrasting experiences reveal about the challenges of demonstrating value, maintaining political support and building a sustainable public health system. The Center for Public Health Systems at Columbia's Mailman School of Public Health conducts needed research, facilitates public discussions, develops policy proposals and provides educational programs, all with the goal of encouraging a better, more efficient and more equitable public health system. This work builds on the recognition that the nation’s public health system is currently under-resourced, under-paid and under-valued, and that a stabilized and strengthened system would benefit all of us.