Maximizing the Value of Philanthropic Efforts through Planned Partnerships between the U.S. Government and Private Foundations

APPENDIX C:
U.S. GOVERNMENT AND FOUNDATION HEALTH AND SOCIAL SERVICES SPENDING

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  1. Data
  2. Foundation Funding
  3. USG Funding
  4. Foundation and USG Funding Priorities and Trends Compared
  5. Conclusions

In 2006, total individual giving by individual Americans to charitable causes was about $246 billion, with about $113 billion devoted to causes in health and social services (Giving USA, 2007).[1] Similarly, the Foundation Center estimates that American foundations made grants totaling $39 billion in 2006, of which roughly $28 billion was spending on programming in the health and social services areas. In addition to these private donations, we estimate that in 2006, Americans provided another $720 billion to meet health and social services needs through grant and assistance programs operated by the U.S. government (excluding large entitlement programs such as Medicare, Social Security, and Medicaid). Unlike individuals, foundations and the USG operate large, carefully planned and budgeted programs, in order to address specific needs among targeted groups or geographic areas.

While estimates of total philanthropic spending provide a rough method of comparing philanthropic giving by different components of society, this Appendix examines the distribution of foundation and USG spending, consistent with the aims of this study. Distributions are examined both geographically and across six programmatic sectors within health and social services: development, education, environment, health, human services, and relief. Identifying areas where foundations and USG currently focus their resources establishes a context for analyzing foundation-USG interactions. Specifically, given ASPE’s interests, MPR used available data to answer the following research questions:

1.    What is the level of foundation and USG funding on international health and social service initiatives? What types of problems does it address and in what geographic regions?

2.    What is the level of foundation and USG funding on domestic health and social service initiatives? What types of problems does it address?

This Appendix describes data sources used to address these questions and includes a few caveats about interpreting the spending estimates (Section A). We then describe foundation spending (Section B), followed by USG spending (Section C). In both sections, reflecting the overall study’s emphasis on international initiatives, international spending is examined first, beginning with spending by sector and then spending by international geographic region. Domestic spending is presented by sector only. Spending patterns across sectors and regions are then addressed in Section D, followed in Section E by a brief summary.

A.    Data

No single source provides comprehensive and relevant data on domestic and international spending for foundations and USG. Therefore, three different sources were used to estimate funding levels (Table A.1). Data from the Foundation Center were used to estimate both international and domestic spending by U.S.-based foundations. Data from the Organization for Economic Cooperation and Development (OECD) and from the Federal Assistance Award Data System (FAADS) were used to estimate international USG spending and domestic USG spending, respectively.[2]
TABLE A.1:
DATA SOURCES SELECTED FOR OVERVIEW OF FOUNDATION AND USG PHILANTHROPIC SPENDING
  International Domestic
Foundations Foundation Center Grants Database Foundation Center Grants Database
USG Official Development Aid (ODA) data, compiled by OECD’s Development Assistance Committee (DAC) Federal Assistance Award Data System (FAADS)

For domestic and international spending, data were broken into six domains or sectors: (1) development,[3] (2) education, (3) environment, (4) health, (5) human services, and (6) relief. Funding outside of these domains was excluded from the estimates. Funding levels are presented for several recent years: 2002, 2004, and 2006—the most recent year for which data are available. For international funding, data were also broken out by geographic region, using the World Bank’s regional grouping.

Through literature searches and conversations with experts, we identified each of these sources as containing the most comprehensive and relevant information about USG and foundation philanthropic spending. Although these data represent the best publicly available information to characterize foundation and USG philanthropic spending, several limitations are important to note:

Thus, differences between foundation, USG international, and USG domestic spending reported in this memo reflect (1) differences in actual spending and (2) differences in how each data source collects information, defines and categorizes spending, and reports the information. This conflation between actual and reported spending means that although our data sources are the best available, the estimates we present imprecisely answer the research questions posed above. Despite this limitation, we are confident that the data and approaches we have used provide useful (and heretofore unavailable) contextual information.

B.    Foundation Funding

The Foundation Center grants database contains all grants greater than $10,000[4] that were made by a sample of more than 1,000 independent foundations, corporate foundations, operating foundations with substantial grant-making programs, and community foundations.[5] All of the 800 largest foundations (based on annual giving) are included in the sample, as are the 10–15 largest foundations in each state and other foundations that report their spending to the FC.

Most foundation spending occurs in the domestic arena (Table B.1).[6] In 2006, 75 percent of total foundation philanthropic spending was domestic. However, the share of foundation funding devoted to the international sphere almost doubled from 2002 to 2006. This growth was due to declines in real domestic spending over the period as well as to increases in real international spending.[7]
TABLE B.1:
SUMMARY OF FOUNDATION PHILANTHROPIC SPENDING, 2002–2006
(IN MILLIONS 2006 $)
  2002 2004 2006
Category Amount % of Total Amount % of Total Amount % of Total
International (all countries) 1,685.9 13 2,487.6 21 3,413.8 25
Domestic 11,070.7 87 9,493.8 79 10,382.6 75
Total[8] 12,756.6   11,981.4   13,796.4  

Across sectors, the largest share of international foundation spending was devoted to health, ranging from 46 percent in 2002 to a high of 63 percent in 2004 (Table B.2). Real spending on health grew by 130 percent from 2002 to 2006 (percentage not shown).
TABLE B.2:
FOUNDATION INTERNATIONAL PHILANTHROPIC SPENDING BY SECTOR, 2002–2006
(all countries; IN MILLIONS 2006 $)
  2002 2004 2006
Sector Amount % of Total Amount % of Total Amount % of Total
Development 420.2 25 425.9 17 798.4 23
Education 190.6 11 174.4 7 245.2 7
Environment 173.5 10 178.9 7 286.1 8
Health 779.7 46 1,558.1 63 1,796.4 53
Human Services 97.4 6 96.9 4 150.7 4
Relief 24.4 1 53.2 2 136.9 4
Total 1,685.9   2,487.6   3,413.8  

Domestically, however, spending devoted to health represented only a quarter or less of foundation philanthropic spending, with education representing the largest domestic sector (Table B.3). Total real domestic spending fell by six percent from 2002 to 2006 (percentage not shown), and spending fell in all sectors except health. In contrast, spending on all international sectors increased, often substantially; development spending almost doubled between 2002 and 2006, and spending on relief more than quintupled (albeit from a low base).
TABLE B.3:
FOUNDATION DOMESTIC PHILANTHROPIC SPENDING BY SECTOR, 2002–2006 (IN MILLIONS 2006 $)
  2002 2004 2006
Sector Amount % of Total Amount % of Total Amount % of Total
Development 1,218.6 11 1,232.7 13 1,107.9 11
Education 4,526.5 41 3,703.1 39 4,060.9 39
Environment 692.5 6 550.6 6 637.4 6
Health 2,492.5 23 2,195.1 23 2,598.1 25
Human Services 1,960.4 18 1,744.9 18 1,868.5 18
Relief 180.3 2 67.4 1 109.8 1
Total 11,070.7   9,493.8   10,382.6  

Foundation international spending in the developing world was heavily concentrated in sub-Saharan Africa in 2006—nearly half of all spending was in this region (Table B.4). This represents a very substantial increase—in total dollars and share of spending—from 2002. In that year, spending in sub-Saharan Africa constituted 29 percent of all spending in the developing world, slightly less than the share of spending directed to Latin America and the Caribbean (30 percent). There was a significant overall increase in international spending in developing countries (46 percent, not shown) from 2002 to 2006.
TABLE B.4:
Foundation International PHILANTHROPIC SPENDING BY region, 2002–2006
(developing countries, IN MILLIONS 2006 $)
  2002 2004 2006
Region Amount % of Total Amount % of Total Amount % of Total
East Asia and the Pacific 106.9 17 99.0 17 129.5 14
Eastern Europe and Central Asia 52.4 8 46.6 8 15.9 2
Latin America and Caribbean 195.7 30 112.0 19 163.6 17
Middle East and North Africa 17.7 3 15.6 3 42.4 4
South Asia 83.4 13 123.7 21 121.6 13
Sub-Saharan Africa 188.3 29 199.7 34 470.1 50
Total 644.4   596.6   943.1  

C.    USG Funding

Data on USG philanthropic spending were obtained from two different sources. For international spending in developing countries, OECD data were used. Specifically, the OECD.Stat data warehouse reports Official Development Assistance (ODA) to all low- and middle-income countries as measured by per capita Gross National Income. ODA is reported by sector and recipient country. Dollar flows include grants, commodities, services, and certain capital transactions. The most comprehensive source of USG domestic philanthropic spending is the FAADS, compiled by the U.S. Census Bureau. FAADS data are also closest in content to foundation spending as reported by the Foundation Center and to this study’s operational definition of philanthropic spending.[9] FAADS is a central repository of data on USG financial assistance provided by grants, loans, insurance, and transfer payments. We used OECD sectors and FAADS codes to classify USG spending into our six sectors.

Compared to foundation spending, USG philanthropic spending was even more weighted toward the domestic sphere (Table C.1). International spending represented just 1.5 percent of all USG philanthropic spending in 2002. However, the amount of international spending doubled by 2004 and, due to this increase and to a decline in domestic spending, represented 3.5 percent of all USG philanthropic spending in that year.
TABLE C.1:
SUMMARY OF USG PHILANTHROPIC SPENDING, 2002–2006 (IN MILLIONS 2006 $)
  2002[10] 2004 2006
Category Amount % of Total Amount % of Total Amount % of Total
International 11,854.4 2 23,946.5 4 23,157.9 3
Domestic 769,835.4 99 654,481.5 97 696,916.9 97
Total 781,689.8   678,428.0   720,074.8  

Development spending received the largest share of ODA from 2002 to 2006, ranging from roughly half to two-thirds of total USG international philanthropic spending (Table C.2). Health spending followed at just under 20 percent in 2002 and 2006 but less—12 percent—in 2004. Development spending nearly tripled from 2002 to 2004, coinciding with USG reconstruction work in Iraq.
TABLE C.2:
USG INTERNATIONAL PHILANTHROPIC SPENDING BY SECTOR, 2002–2006 (IN MILLIONS 2006 $)
  2002 2004 2006
Sector Amount % of Total Amount % of Total Amount % of Total
Development 5,647.6

48

15,507.2 65 11,140.2 48
Education 317.3

3

652.1 3 477.1 2
Environment 424.8

4

1,287.1 5 1,057.3 5
Health 2,201.1

19

2,879.8 12 4,189.6 18
Human Services 2,013.1

17

1,811.5 8 1,449.5 6
Relief 599.0

5

1,566.7 7 2,776.8 12
Multisector 651.5

5

242.2 1 2,067.5 9
Total 11,854.4   23,946.5   23,157.9  

The largest amount of all USG philanthropic spending was directed toward domestic human services, at nearly $280 billion in 2006 (Table C.3).[11] Development spending represented nearly a third of USG domestic spending in all three years.
TABLE C.3:
USG DOMESTIC PHILANTHROPIC SPENDING BY SECTOR, FY 2002–2006
(IN MILLIONS 2006 $)
  2002 2004 2006
Sector Amount % of Total Amount % of Total Amount % of Total
Development 251,465.1 33 200,004.1 31 222,759.7 32
Education 98,601.3 13 90,739.0 14 108,521.3 16
Environment 6,622.1 1 7,709.7 1 23,141.3 3
Health 54,480.0 7 42,935.0 7 41,783.1 6
Human Services 356,104.2 46 310,621.8 48 279,355.4 40
Relief 2,562.7 0 2,471.9 0 21,356.1 3
Total 769,835.4   654,481.5   696,916.9  

In 2006, countries in the Middle East and North Africa region received the largest share of USG ODA (Table C.4). The regional distribution of ODA changed substantially toward this region from 2002 to 2004, in large part due to a significant increase in ODA to Iraq. Spending in sub-Saharan Africa was roughly equivalent to spending in the Middle East and North Africa in 2006 (32 percent compared to 33 percent, respectively).

TABLE C.4:
USG International PHILANTHROPIC SPENDING BY region, 2002–2006 (IN MILLIONS 2006 $)
  2002 2004 2006
Region Amount % of Total Amount % of Total Amount % of Total
East Asia and the Pacific 872.0 10 577.9 4 725.1 4
Eastern Europe and Central Asia 1,664.3 19 1,090.8 8 1,171.0 7
Latin America and Caribbean 1,332.3 15 1,911.8 15 1,921.1 11
Middle East and North Africa 1,627.4 18 4,698.0 36 5,711.1 33
South Asia 747.6 8 1,067.7 8  2,165.9 13
Sub-Saharan Africa 2,658.4 30 3,738.7 29 5,602.4 32
Total[12] 8,902.0   13,084.9   17,296.6  

D.   Foundation and USG Funding Priorities and Trends Compared

U.S.-based foundations and USG together provided $734 billion in philanthropic funding in 2006, at home and across the globe. To paint a clearer picture of the differences and similarities in their philanthropic agendas and priorities, we provide in this section bar charts showing the distribution of their spending across sectors and geographic regions, using the information presented in tabular form in sections B and C.

Internationally, both foundation and USG spending reflect strong priorities for health and development efforts.

As measured by the share of funding in 2006 devoted to each sector, foundations give health top priority (53 percent of spending, figure D.1), but they also focus strongly on development (23 percent). In 2006 the majority of foundation international spending on health was directed to public health (38 percent), followed by AIDS research (11 percent) and reproductive health care facilities (10 percent) (not shown).

Like foundations, USG also focused spending on health and development, although the relative order is reversed. USG devoted 48 percent of its international philanthropic spending to development and 18 percent to health (Figure D.2). Spending on relief was also important for USG, representing 12 percent of all international funding in 2006.

FIGURE D.1
DISTRIBUTION OF FOUNDATION INTERNATIONAL SPENDING BY SECTOR IN 2006

DISTRIBUTION OF FOUNDATION INTERNATIONAL SPENDING BY
SECTOR IN 2006

FIGURE D.2:
DISTRIBUTION OF USG INTERNATIONAL SPENDING BY SECTOR IN 2006
(IN MILLIONS 2006 $)

DISTRIBUTION OF USG INTERNATIONAL SPENDING BY SECTOR
IN 2006

Sub-Saharan Africa and the Middle East receive the bulk of foundation and USG philanthropic funding, respectively.

Foundation international spending is most heavily concentrated in sub-Saharan Africa, with half of this spending focused on that region and less than five percent on the Middle East and North Africa (Figure D.3).

The USG’s engagement in the Middle East is reflected by the relatively high allocation of philanthropic spending to the Middle East and North Africa region (33 percent; Figure D.4). At 32 percent, however, USG spending in sub-Saharan Africa is roughly equivalent to spending in the Middle East and North Africa.

FIGURE D.3
DISTRIBUTION OF FOUNDATION INTERNATIONAL SPENDING BY GEOGRAPHIC REGION IN 2006 (IN MILLIONS 2006 $).

DISTRIBUTION
    OF FOUNDATION INTERNATIONAL SPENDING BY GEOGRAPHIC REGION
    IN 2006

FIGURE D.4:
DISTRIBUTION OF USG INTERNATIONAL SPENDING BY GEOGRAPHIC REGION IN 2006 (IN MILLIONS 2006$)

DISTRIBUTION OF USG INTERNATIONAL SPENDING BY GEOGRAPHIC REGION IN 2006

Priorities in domestic philanthropy differ between foundations and USG.

In 2006, foundations focused spending within the United States on education and health (Figure D.5). Together these sectors made up 64 percent of their domestic spending. In contrast, USG domestic philanthropy was heavily concentrated on human services and development (Figure D.6). Combined, these two sectors took up 72 percent of USG spending.

FIGURE D.5:
DISTRIBUTION OF FOUNDATION DOMESTIC SPENDING BY SECTOR IN 2006 (IN MILLIONS 2006 $)

DISTRIBUTION OF FOUNDATION DOMESTIC SPENDING BY SECTOR
    IN 2006

FIGURE D.6:
DISTRIBUTION OF USG DOMESTIC SPENDING BY SECTOR IN FY 2006 (IN MILLIONS 2006 $)

DISTRIBUTION
    OF USG DOMESTIC SPENDING BY SECTOR IN FY 2006

E.    Conclusions

Identifying spending patterns and trends provides insight into foundation and USG decision making by revealing where they choose to spend their limited funds. Internationally, foundations, or at least a few large foundations, have determined that the health sector and sub-Saharan Africa present the greatest opportunities for impact. USG shares these priorities, although, of course, national security considerations and political necessities have also shaped USG spending. Domestically, foundations favor the education sector, particularly spending in higher education. In contrast, almost three-fourths of USG spending occurs in human services and development.

Just as geopolitical events have significantly altered the pattern of USG international spending, overall trends in foundation spending hint at the impact of a few large foundations. Mostly due to the falling stock market and consequent drops in foundation endowments, overall foundation spending decreased from 2002 to 2004 (Table B.1), continuing a drop from 2000. Yet the decline is not evident in the international data because of the very large contribution to international spending by the Bill & Melinda Gates Foundation. Without the Gates Foundation, international giving would have decreased by four percent from 2002 to 2004 (Foundation Center Report on International Giving, 2006). The outsized impact by Gates and a few other large, often new foundations (such as Hewlett and Google) provides new opportunities for foundation-USG interaction.


Endnotes

[1] Giving USA estimates 2006 individual giving using adjusted data from five sources: data on itemized charitable deductions from the Internal Revenue Service (IRS), survey data on giving by individuals that do not itemize their deductions, information from large disaster relief organizations, press reports of large donations, and estimates of individual charitable bequests. Given the limitations that result from sampling and estimating changes over time, Giving USA numbers should be viewed as approximate. As the foundation and USG spending estimates in this Appendix only include health and social services spending, MPR sought to isolate individual giving in those areas. This was done by subtracting estimated individual giving to religion ($96 billion), arts & culture ($8 billion), and foundations ($30 billion) from total individual giving.
[2] The United States Agency for International Development Greenbook also presents information on USG philanthropic spending. However, the OECD Official Development Aid (ODA) data are more appropriate for the study because they classify spending by purpose, enabling a classification by sector. As the Greenbook website reports, “The only authoritative source for U.S. government assistance by purpose is the OECD Development Assistance Committee (DAC) Development Database on Aid from DAC Members.” http://qesdb.usaid.gov/gbk/faq.html [accessed October 12, 2008].
[3] For foundations, development spending includes spending on community development, economic development, agricultural development, civil society development, and so on. For USG, development includes spending on government and civil society, social infrastructure and services, and economic infrastructure, including transportation, agriculture, forestry and fishing, industry, mining, and so on.
[4] The FC grants database does include some grants with awards between $1,000 and $10,000. Typically these are grants that the FC has identified through a project or grants that are attached to a grants list filed electronically by the largest foundations.
[5] Roughly three-quarters of the foundations in the sample are independent foundations. The database does not include spending by public charities. Unlike foundations, public charities typically raise funds from multiple sources (including foundations), often provide services, and may receive revenues for services provided. Some well-known public charities include the Clinton Foundation and the Ashoka Foundation.

[6] All presented foundation and USG spending is programmatic and excludes operational spending.

[7] All dollar amounts presented in this memo have been adjusted for inflation using the most widely used measure of inflation, the Consumer Price Index for All Urban Consumers (CPI-U).
[8] These amounts only include grants in the Foundation Center grants database.
[9] Ideally, each federal assistance program would be analyzed to determine the appropriate sector. We used a more efficient classification method that incorporated 176 functional subcategories determined by USG agencies. Two MPR researchers independently examined each subcategory and determined the most appropriate sector. Some codes were in multiple functional subcategories; these codes were individually evaluated and assigned to the most appropriate sector.
[10] This is the calendar year for international spending and the USG fiscal year for domestic spending.
[11] We excluded from the analysis three major entitlement programs: Social Security, Medicare, and Medicaid. These programs do not fit well within the rubric of “initiatives.” If included, these entitlements combined would approximately double total USG domestic philanthropic spending. Human services and health would then represent 47 and 33 percent of domestic spending, respectively, and development would constitute 12 percent of total USG domestic philanthropic spending in 2006.
[12] This total is smaller than the overall total for USG international spending because some spending (roughly $5.7 billion) is not identified by recipient country (“unspecified bilateral” or not reported).


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