Big Health Departments Get Most of the Tech Money

Some local health departments in the United States received extra money to modernize their data systems. A 2023 survey asked who got this funding and who did not. The findings show that bigger departments had a clear advantage.

Departments serving at least 500,000 people were far more likely to receive money than those covering fewer than 50,000 residents. The larger offices had about 3.5 times higher odds of getting funded. Smaller jurisdictions often missed out completely.

The way an agency is governed also mattered. State-run health departments had much lower odds of receiving funds compared to agencies with shared governance. Their chances were roughly 0.22 times those of shared-governance offices. This suggests state-controlled departments faced steeper barriers.

The funding was intended to support electronic health records, outbreak tracking, and staff who can analyze data. Yet the money mostly went to departments that were already large and digitally advanced. That leaves smaller and less tech-ready areas further behind.

To close this gap, funding should be based on need rather than size or existing resources. Regional support teams could help smaller departments build the skills and systems they require. Without these changes, the divide between big and small health offices will likely grow.