Updated April 2026 · U.S. Census Bureau data
Health Spending Per Capita
Health spending per capita includes city-funded public health programs, clinics, immunizations, and environmental health. 396 cities are ranked. Some major cities operate large public-health departments; many smaller cities defer this function to county health districts. Read the score in context of the city's service mix.
Related Rankings
Top 100 Cities by Health Spending Per Capita
Showing top 100 of 396 cities
What the Numbers Show
At the top of the ranking, Alameda, CA posts $4,986, with Maricopa, AZ close behind at $4,707. At the other end, Kent, WA sits at $0. The spread between top and bottom in this metric reflects real differences in service mix, peer-group cost structure, and policy priorities, not just budget size.
Per-capita figures can be sensitive to population estimates: a city whose American Community Survey count is undercounting recent growth will look like an outlier-high spender. Where rankings rely on payroll, employee counts, or pension data, the input dataset is noted in the FAQ. Always pair a single ranking with the underlying city profile before drawing fiscal-health conclusions.
Methodology
Per-capita figures divide the relevant Census-reported expenditure or revenue line by American Community Survey population estimates. Per-capita ratios are most useful inside a population peer group; comparing a 60,000-resident city to a 600,000-resident city directly can mislead because larger cities run more services and absorb regional commuters. For full methodology and weight-by-weight breakdown of the composite Fiscal Health Score, see the methodology page. Underlying datasets include the Census Annual Survey of State and Local Government Finances, the Lincoln Institute's Fiscally Standardized Cities for the 150 largest cities, and best-practice guidance from the Government Finance Officers Association.
Frequently Asked Questions
What is the health spending per capita ranking?
Health spending per capita includes city-funded public health programs, clinics, immunizations, and environmental health. 396 cities are ranked. Some major cities operate large public-health departments; many smaller cities defer this function to county health districts. Read the score in context of the city's service mix. Alameda, CA currently leads the ranking at $4,986.
Where does the data come from?
Every figure traces back to U.S. Census Bureau primary data: the Annual Survey of State and Local Government Finances for spending and revenue, and the American Community Survey for population estimates used to compute per-capita ratios. Pension data, where used, comes from the Public Plans Database; federal grant flows come from USASpending.gov.
How often is the ranking updated?
The Census Bureau publishes the Annual Survey of State and Local Government Finances roughly 18 months after the close of the fiscal year. CitySpend rebuilds the rankings whenever new Census microdata is released, typically once a year. The current data reflects the most recent Census release available at the page-update time shown above.
Is being ranked at the top always good?
Not always. Top-ranking cities on a per-capita spending metric may simply be larger metros absorbing regional commuters or operating broader services than peers. Always read a top-ranked city in the context of its peer group, service mix, and audited financial reports.
How is this metric calculated?
Per-capita figures divide the relevant Census-reported expenditure or revenue line by American Community Survey population estimates. Per-capita ratios are most useful inside a population peer group; comparing a 60,000-resident city to a 600,000-resident city directly can mislead because larger cities run more services and absorb regional commuters.
Health spending per capita includes city-funded public health programs, clinics, immunizations, and environmental health. 396 cities are ranked. Some major cities operate large public-health departments; many smaller cities defer this function to county health districts. Read the score in context of the city's service mix.