Utah's near the bottom in how much money it receives from the Centers for Disease Control and Prevention for public health programs to prevent injury and disease. But it's also one of the healthier states, according to a new report.

Utah receives $14.81 per person from the CDC for such programs, ranking 46. That's the lowest amount in the region and less than half of what Southern states receive, according to "Shortchanging America's Health 2008," by Trust for America's Health, which looks at how federal public health dollars are spent in each state.

The disparity is both disturbing and understandable, said Dr. David Sundwall, Utah Department of Health director.

"It's always a little disconcerting when you see a ranking of any kind and we're not at the top," he said. "I think we do a pretty good job." On the other hand, Utah doesn't have the same challenges of some states, either. Fewer Utahns smoke, the state has a lower cancer rate and childhood obesity, while concerning, is more rampant elsewhere.

"We have a lot to be be proud of. If I were passing out money, I might give it to states with worse issues. But that doesn't mean we aren't very concerned about competing for these funds," Sundwall said.

Utah health officials recently applied for a CDC exercise and obesity/fitness initiative grant, one Sundwall said they're anxious to get. It would also correct some of the imbalance.

The report, released today, focuses on improving public health, which includes chronic disease and infectious disease prevention, as well as disease, disaster and bioterrorism preparedness.

"Chronic diseases are the driver of health-care costs today," said Jeff Levi, executive director of the trust. "And there's worry about health-care costs doubling by 2012. Chronic diseases have an impact on both quality and length of life. ... We're not investing in prevention activities on a range of issues. If we don't pay now, we will pay dearly later."

The report criticizes the current focus on caring for sick people, while neglecting efforts to prevent disease through public health measures.

CDC funding for prevention varied from a per capita low of $13.61 in Kansas to a per capita high of $69.76 in Alaska. The national average is $17.23 per person.

The report also looks at a state's own public health funding, but warns that differences in state reporting make it hard to do an apples-apples comparison. The range was $3.46 in Nevada to $152.66 in Hawaii. Utah came in near the middle at $31.45 per person (No. 27).

Chronic disease is responsible for about 70 percent of deaths in America each year, the report says, many of them avoided if "stronger action was taken to promote prevention efforts." Half of men and one-third of women will develop cancer at some point. One-fourth of American adults have heart disease. And two-thirds are overweight or obese. Programs that promote healthy lifestyles and educate could dramatically change those numbers, Levi says.

Utah gets no CDC funding for school health programs, for nutrition and physical activity, especially important with a growing number of overweight children, who are more likely to have health problems later, Levi said. There's no CDC funding for school nurses, either. He said CDC has not been given enough money to adequately provide funding to all the states.

"Obesity is a major public health problem," he said. "You would think Congress and the president would do something about that."

He hopes people will read the report and urge their congressmen to beef up public health funding.

Sundwall praised the CDC as the "white knights of public health," monitoring health issues, surveilling disease and helping health officials stay on top of problems. State lawmakers, he added, have also taken health issues seriously, although he was disappointed they didn't fund an epidemiology surveillance system that's been needed. Funding requests for Utah Partnership for Healthy Weight didn't go anywhere, either.

Sundwall said Utah gets money from other sources, as well. And it has "some of the best programs. The Gold Medal Schools Program is the envy of the nation." He also lauds "Action for Healthy Kids to promote wellness through the school system, a stroke and heart disease prevention program and others. Private-sector partnerships provide funding, as well.

The entire report is online at www.healthyamericans.org.

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