The Impact of Public Health Spending on California STD Rates

Abstract

This study assesses the impact of county-level public health spending on rates of sexually transmitted disease (STD) in California. Across a variety of empirical specifications, increases in own-county public health spending reduce rates of gonorrhea and syphilis. Indeed, a $1 increase in per capita public health spending reduces the gonorrhea (syphilis) rate by approximately 0.30 (0.60) percent. Spillover effects are also associated with public health spending, as increases in border-county spending reduce STD rates. To varying degrees of significance, county STD rates are also sensitive to lagged STD rates, county racial composition, whether or not a public university is located within the county, and a yearly time trend.