ArticleArchives of public health = Archives belges de sante publique2025
Associations between previous local health expenditures and COVID-19 mortality outcomes large cities in the united states: results from a forward-selecting linear regression analysis.
Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDecision-making before the COVID-19 pandemic-including the budgeting and expending of public health financing-may have impacted the ability of health systems to mitigate the health consequences of the outbreak. Theoretically, greater investments in public health preceding an outbreak ought to improve health outcomes during an emergency response. Following this reasoning, this research investigates the relationship between local public health expenditures and pandemic-related mortality in the 50 most populous cities in the United States in 2020.
methodsForward-selecting linear regression models were used to examine this relationship. Dependent variables included local-level measures of the excess mortality and COVID-19 mortality rates; the primary independent variable was the five-year average of local public health expenditures per capita (2015-2019). Data on other demographic, socioeconomic, and pandemic response considerations that may have modified or confounded this relationship were included in regression models.
resultsMultiple linear regression models suggested that previous local government public health expenditures were not meaningfully associated with improved pandemic mortality outcomes as measured by excess mortality or reported COVID-19 mortality. Instead, results suggest that education and temporal considerations were the factors that were significantly associated with mortality levels during the first year of the pandemic in large cities in the United States.
conclusionsAcknowledging broader public health financing trends that are characterized by decreasing and unpredictable funding streams, these results suggest that addressing public health emergencies at the scale of the COVID-19 pandemic in the United States will likely require more substantial and sustained investments in public health, nuanced and data-informed approaches for allocating financing, structural changes to the public health system that address social-determinants of health, or a combination of these approaches.
trial registrationNot applicable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.