evidence: The following charts explore high-level trends in public health and related spending over time in the U.S. and other similarly wealthy countries (OECD nations with above average GDP and GDP per capita), as well as spending for public health at the federal vs. state and local levels in the U.S. [...] State and local spending accounts for most public health spending in the U.S. In the U.S., state and local governments account for the majority of national spending on public health activities. In 2018, state and localities spent $81.5 billion on public health, while federal public health spending was $12.0 billion.