Blog: Why public health funding might be Indiana's 'most important legislative issue' in 2023

It’s been said that the COVID-19 pandemic didn’t create new challenges in communities so much as it exposed pre-existing ones. In Indiana, one challenge that came into focus throughout the pandemic is the state’s low investment in public health, which may be the cause of Indiana’s poor showing in key measures of health outcomes. Data and graphics by the Indiana Department of Health and the Governor's Public Health Commission

Pre-pandemic, Indiana’s per-person spending on public health was $55, compared to the national average of $91 per person, ranking it 45th out of 50 states and the District of Columbia, according to U.S. News and World Report and America’s Health Rankings.

Statistics also show that Indiana performs poorly in public health indicators compared to other states. For example, it ranks 45th for smoking and tobacco use, 46th for rates of obesity, 43rd for mental health and 41st for childhood immunizations. The state’s life expectancy rates have been declining since 2010 and now stand at 77 years—almost two years below the U.S. average of 78.8, placing Indiana 40th in the nation. Rising deaths from drugs, alcohol and suicide, as well as rising rates of chronic diseases like cancer and heart disease, also contribute to Indiana’s health challenges.

Data and graphics by the Indiana Department of Health and the Governor's Public Health Commission

But amid the discouraging statistics, change might be underway in the Hoosier state, starting with how much it invests in the health of its citizens. Beginning in August 2021, the Governor’s Public Health Commission spent a year researching and traveling across the state to talk with and listen to public health professionals, medical professionals, business leaders, elected and appointed officials and residents.

Here’s a quick summary of the findings and what’s next for Indiana’s public health funding.
Data and graphics by the Indiana Department of Health and the Governor's Public Health Commission
What’s happening? Due to lagging public health funding in Indiana, the Governor’s Public Health Commission has issued its recommendations on how to improve the health of Indiana residents. The commission recommends all Hoosiers have access to a set of core public health services from their local county health departments.
To bring Indiana up to the average amount of public health spending per person in the U.S., the commission recommends allocating an additional $242 million annually from the state budget.

State Health Commissioner and Co-Chair of the commission, Kristina Box, MD, FACOG says: “If passed, the Indiana Department of Health would work with local health departments to define the core services available in each county. We would also provide additional staff resources at a district level to support services such as accreditation and legal consultation.”

What are people saying about this potential change? Former State Senator and Co-Chair of the commission Luke Kenley says: “I was shocked to learn that despite all the good things Indiana has done over the last 25 years, our public health picture is pretty poor… If you have a good healthy community, good healthy workforce, this is so attractive to bring people and business to Indiana. 

“In my opinion, this is the most important legislative issue to come before the Legislature in the next session. Indiana has been uniquely successful in developing our K-12 education system, our tax structure and support for businesses and infrastructure…to me, this (public health) is the last area where we have a very poor performance compared to other states and we need to improve.”

When will it happen? The Indiana Legislature will debate public health spending during the session that begins in January. If additional funding is approved, it doesn’t automatically ensure more public health dollars will reach all Indiana citizens. Each Indiana county’s elected officials would also have to vote on whether or not to accept the additional resources and new services for their health departments. So, it’s still at the discretion of local governments.

If additional funding is approved by the Legislature, each county would also have a voice in what basic services would be delivered locally, such as emergency preparedness, maternal/child health services, immunizations and birth and death records.
Mindy Waldron
How might the dollars be spent in Allen County? Mindy Waldron, Allen County Department of Health Administrator and member of the commission, says: “In Allen County, we might choose to address mental health, school health, opioid issues, emergency preparedness betterment and planning, ways to address chronic disease like diabetes, and how to best use epidemiology to address public health concerns.”

Meg Distler, Executive Director of the St. Joseph Community Health Foundation in Fort Wayne says, “People might interpret this additional funding as increasing regulatory programs. Rather, this funding will increase local services that improve the health of individuals. Many other states provide this level of funding for local programming that has created healthier residents for the workforce, schools, and our community.”

How can you make your voice heard? Find more information at Contact your state legislator with your opinion by searching here:

Data and graphics by the Indiana Department of Health and the Governor's Public Health Commission

This story is part of a series on solutions developing to meet people's needs in Northeast Indiana, underwritten by Brightpoint and St. Joseph Community Health Foundation. The author, Mary Tyndall, is Double Up Program Manager and Chief Storyteller at St. Joseph Community Health Foundation.