Local public health department (LPHD) spending can reduce population-wide mortality. A recent study featuring PISC External Advisory Board Member Jeffrey Hom, MD, MPH, compares changes in LHPD spending to county-level sociodemographic indicators of public health needs. 793 counties in the United States in 2008 and 2016 were analyzed using multivariable linear regression. Results indicate that LPHD increases spending in communities with high populations of residents over the age of 65 and high unemployment rates. However, LPHD spending remains the same for communities with a higher population of people who identify as Black, Hispanic, or have a high percentage of poverty within the community. This spending directive can be related to the “social, political, and structural barriers” within the United States. In the future, the LHPD should direct more spending towards underserved communities, equitably reducing population-wide mortality throughout the United States.