According to analysis by the nonpartisan Trust for America's Health, Utah ranks 46th in the amount of money, per capita, it received from the Centers for Disease Control and Prevention, at almost $15 a person.

That ranking - and an overall drop in national health spending - has some of Utah's city and county health departments turning down federal funds, such as money targeting tuberculosis. The catch: It costs more to implement the initiatives than what the federal and state governments provide.

Southwest Utah - which serves five counties, including fast-growing Washington - has turned away federal money for monitoring tuberculosis patients and screening for and treating sexually transmitted diseases.

Southwest now focuses its local STD funds on educating doctors and tracking down infected partners, and it no longer drives out to TB patients to ensure they take their medications. Instead, nurses monitor compliance over a video phone.

"It's far cheaper to turn back the contract and run the program the way it needs to be done," said David Blodgett, Southwest's director. Still, the bulk of his budget, and of Utah's 11 other health departments, comes from the federal government.

"The more those federal dollars go down, the less we do any of the regular activities of public health [including] immunizations, restaurant inspections, protecting food, water and air, providing messages that empower people to lead healthier lives," Blodgett said.

The declining funding has translated to major cuts to Utah budgets for cancer, chronic disease prevention, HIV/AIDS, infectious diseases, immunizations, diabetes, preventive health and terrorism preparedness, according to data from Trust for America's Health, based in Washington, D.C.

President Bush's proposed fiscal year 2009 budget calls for a $433 million cut in CDC funding. In Salt Lake County, that means health officials will have to stop stockpiling supplies for a pandemic flu, including antiviral medications, face masks and satellite phones.

"That is a significant cut to a significant responsibility that public health has had," said Gary Edwards, executive director of the Salt Lake Valley Health Department.

As federal funds continue to plunge, more health departments may say no to the program-specific federal money when regulations are attached. That worries Lloyd Berentzen, director of the Bear River Health Department and president of the Utah Association of Local Health Officers.

"You don't know how far it will go before the overall public-health system starts to break," he said.

Besides analyzing federal and state spending on public health in fiscal year 2007, the Trust for America's Health also looked at the health of each state. It shows Utahns have some of the lowest rates of hypertension, diabetes, Alzheimer's and obesity.

David Sundwall, executive director of the Utah Department of Health, said he is trying to get more CDC money for Utah by inviting three federal officials to the state at the end of the month.

Utah's local health-department budgets are low enough that Rep. Stephen Clark, R-Provo, recently proposed raising county property taxes to generate $7.1 million. Opposed by county officials, his bill died, but the idea will be studied over the summer.

Local health departments "don't have a lot of money to be able to handle catastrophes. . . . Many of them are just barely keeping the doors open," Clark said.

hmay@sltrib.com

Ranking of where CDC health dollars were spent, per capita, in fiscal 2007

Utah's rankings on health indicators (1 is the worst)

16. Number of new human West Nile Virus cases in 2007.

19. Three-year adult asthma rates.

40. Alzheimer cases in 2000.

38. Percentage of preterm births in 2005.

39. Estimated new adult cancer cases in 2008.

Source: Trust for America's Health.