Tracking our investments in public health: what have we learned?

A voluntary public health expenditures reporting system existed in the United States for over 25 years, tracking and reporting trends in health department expenditures, revenue streams, functions, and programs. Today, no such system exists and no data are available to help us understand how and where public health dollars are being spent and the trends during good and bad economic times. This article discusses the history of and lessons learned from the former public health expenditures reporting system and more recent demonstration projects that experimented with reporting by essential public health services. The article also explores how what we have learned can be used for developing and implementing a system today to meet public health and public policy needs.