• Courtnee Melton-Fant, Scott Howard, and Xueyuan Cao.
• From the University of Memphis, School of Public Health, Nashville, and the University of Tennessee Health Science Center College of Nursing, Memphis.
• South. Med. J. 2020 Feb 1; 113 (2): 64-69.

ObjectivesA growing body of research has demonstrated the effect of local government spending on health outcomes; however, the effect of spending on different demographic groups is unclear. We combined national and local data to examine the impact of public spending on mortality rates in Tennessee.MethodsWithin-between random effects models to examine the relation between county-level spending and mortality rates.ResultsWe found a significant association between per capita library and kindergarten through grade 12 education spending and mortality outcomes. We also found sex differences in the effects of per capita public health spending and highway spending.ConclusionsThis study provides further evidence that local government spending plays a role in addressing and improving population health and suggests that public spending can have differential effects within a population.

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