Volume 53 | Number S1 | August 2018

Abstract List

Cezar Brian C. Mamaril Ph.D., Glen P. Mays, Douglas Keith Branham Dr.P.H., Betty Bekemeier Ph.D., M.P.H., F.A.A.N., Justin Marlowe Ph.D., Lava Timsina Ph.D.


To estimate the cost of resources required to implement a set of Foundational Public Health Services () as recommended by the Institute of Medicine.

Study Design

A stochastic simulation model was used to generate probability distributions of input and output costs across 11 domains. We used an implementation attainment scale to estimate costs of fully implementing .

Data Collection/Extraction Methods

We use data collected from a diverse cohort of 19 public health agencies located in three states that implemented the cost estimation methodology in their agencies during 2014–2015.

Principal Findings

The average agency incurred costs of $48 per capita implementing at their current attainment levels with a coefficient of variation () of 16 percent. Achieving full implementation would require $82 per capita (=19 percent), indicating an estimated resource gap of $34 per capita.


Substantial variation in costs exists across communities in resources currently devoted to implementing , with even larger variation in resources needed for full attainment. Reducing geographic inequities in may require novel financing mechanisms and delivery models that allow health agencies to have robust roles within the health system and realize a minimum package of public health services for the nation.