While the ongoing spread of COVID-19 is certainly highlighting the shortcomings of the U.S. health system, a report from Kaiser Health News and the Associated Press has charted its decline over the past 10 years. It found that state spending for local health departments has fallen 16 percent per capita since 2010 while spending for local health departments contracted 18 percent over the same period. Approximately 38,000 state and public health jobs have been lost since the 2008 financial crisis which has left a skeletal workforce in what was once considered one of the world's premier public health systems. The situation is only expected to worsen with county budget cuts likely due to the recession.
The report also analyzed current levels of annual public health expenditure across America with three-quarters of the population living in states that spend less than $100 per resident annually. The gap in health expenditure per resident is considerable between states, ranging from $32 in Louisiana to $263 in Delaware. The following infographic provides on overview of the situation based on the report's data, though there was no information available for California. The research also highlighted trends in spending per person in states over the past decade with South Carolina's spending falling 55 percent from 2010 to 2018. Nevada and Kentucky had the second and third highest declines at 33 percent and 32 percent, respectively.