Introduction
This publication reports estimates of recurrent expenditure (referred to as ‘expenditure’ throughout the report) on public health activities in Australia that were funded by the Australian Government and state and territory governments during 2023–24 as well as comparisons with spending back to 2013–14.
The public health expenditure estimates in this report include only funding from key health departments and agencies in each jurisdiction. The estimates exclude funding for public health activities by non-health government departments – such as education, veterans’ affairs, law enforcement, transport and environment – as well as non-government organisations and households. Expenditure on preventive services delivered in clinical settings by general practitioners and other clinicians has also generally been excluded from this report. The exception is expenditure for cervical screening and immunisation provided in a clinical setting which is included. Clinical services make important contributions to public health in Australia, but they are generally outside the scope of this study.
What is public health?
Public health activities focus on prevention, promotion and protection rather than on treatment. It also focuses on populations rather than on individuals, and on the factors and behaviours that cause illness and injury rather than the illness and injury itself.
These activities can take the form of programs, campaigns, or events. They include health education, lifestyle advice, infection control, risk factor monitoring, and tax loadings to discourage unhealthy lifestyle choices and changes to the social environment to support healthier behaviour choices. They apply in a multitude of settings (such as schools, homes, workplaces and media outlets) and relate to a broad spectrum of health issues. Public health activities are conducted by the Australian Government, and state, territory and local government agencies, as well as non-government agencies – such as cancer councils and the Heart Foundation – and private health professionals.
In this report, public health activity is reported against the following eight core categories and one additional category public health not further defined (n.f.d) which comprises public health services that could be a combination of the eight core categories, but which could not be further disaggregated:
- Communicable disease control
- Selected health promotion
- Organised immunisation
- Environmental health
- Food standards and hygiene
- Screening programs
- Prevention of hazardous and harmful drug use
- Public health research
Definitions for each of the core categories are provided in the Technical notes.
While jurisdictions were provided with a data collection guide and an associated template to help collect and classify data according to the above categories, there may be some inconsistencies in the manner in which jurisdictions have classified similar programs and the associated expenditure against the categories above.
Public health funding and expenditure
This report looks at what is spent on public health activities from two perspectives – funding and expenditure. These concepts, while related, are quite distinct and must be kept in mind when considering public health spending.
Defining health funding and expenditure
Health funding
Health funding is reported based on the original source of funds used to pay for health expenditure. While state and territory governments are responsible for three-quarters of total public health expenditure, less than half of this is financed through their own revenue sources.
The Australian Government not only funds its own health programs – administered through the Department of Health, Disability and Ageing, but it also provides grants to states and territories to help finance the public health activities they deliver.
Health expenditure
Health expenditure is reported based on who incurs the spending, rather than who ultimately provides the funding. For example, in many vaccination programs, the expenditure is incurred by state and territory governments, even though a significant portion of the funding is provided by the Australian Government through grants to states and territories.
The estimates of net funding for public health by individual state and territory governments have been derived by deducting their estimated receipts of public health grants received from the Australian Government, from the reported total expenditure incurred by them on public health programs. Consequently, net funding by states and territories is lower than the expenditures they directly incur.
The tables and figures in this report detail expenditure in terms of current and constant prices. The term ‘expenditure at current prices’ refers to expenditure reported for a particular year, unadjusted for inflation. ‘Expenditure at constant prices’, on the other hand, has been ‘deflated’ to remove the effects of inflation, so that expenditure in one year can be compared with expenditure in other years in a series.
This report has three main sections. The first section provides an overview of total government public health expenditure, including per person spending, expenditure by state and territory and spending as a share of total government public health expenditure. The second section examines the sources of funding for these expenditures. The final section focuses on government expenditure across public health activities and their growth over the decade up to 2023–24.