Local authority expenditure and public health provision
What were we trying to do?
To estimate how overall reductions in the public health budgets allocated to local authorities have led to changes in specific areas (‘programmes’) of public health spending such as smoking cessation, sexual health services, and drug and alcohol treatment.
Why was this important?
Spending money on public health (prevention) has been evidenced as being much more cost-effective than spending on treatment (for example on hospital care). However, these budgets have been cut by 28% per person between 2015-16 and 2024-25 after adjusting for inflation.
Most existing research simply describes broad national trends in spending. It does not show whether budget cuts actually caused changes in how money was allocated across different public health services, or how local authorities responded when faced with shrinking budgets.
Understanding these responses matters, because changes in spending priorities can affect population health outcomes and health inequalities.
How did we do it?
We used detailed data on public health budgets and spending for all local authorities in England over time. This allowed us to track how spending on different public health programmes changed as overall budgets rose or fell.
By comparing changes within the same local authority over time, we were able to estimate how reductions in public health budgets led to changed spending priorities on specific programmes, rather than simply describing trends.
Findings
We will report findings of the analysis in due course.
Who did we work with?
More information
Senior Programme Lead
Mike Spence
michael.spence@manchester.ac.uk