News Release

Americans Remain Wary of “Foreign Aid” But Are More Supportive of Spending to Improve Health Abroad

Latest Survey Probes Public’s Knowledge and Views of U.S. Role in Global Health

MENLO PARK, Calif. – While many Americans hold misconceptions and negative views of “foreign aid” in general, they are more supportive of such efforts when described more specifically as “improving health in developing countries,” according to a new survey by the Kaiser Family Foundation.

When it comes to U.S. foreign aid in general, six in 10 Americans (61%) say the U.S. spends too much, and four in 10 incorrectly think that foreign aid is one of the two biggest areas of spending in the federal budget. In comparison, when asked about “improving health in developing countries,” 28 percent say the U.S. spends too much, while nearly two thirds say such spending is too little (23%) or about right (42%).

“The old canard that most Americans do not support ‘foreign aid’ is a misunderstanding of how the public really feels,” said Kaiser President and CEO Drew Altman. “When the specific purposes of spending abroad are put before the public, Americans are more supportive of health and development funding.”

The 2010 Survey of Americans on the U.S. Role in Global Health is the third in a series that aims to illuminate the American public’s views and knowledge of U.S. efforts to improve health for people in developing countries. Other key findings include:

  • Priorities for aid. About half the public says improving education (53%) and helping out after natural disasters (50%) should be a top priority for the president and Congress for aid to developing countries overall. Improving health is seen as a top priority by 37 percent of Americans, similar to the shares who say the top priorities should include reducing poverty (40%), promoting the rights of women (39%) and protecting the environment and fighting climate change (37%).
  • Home vs. abroad. Half the public (49%) says the U.S. should spend its tax dollars on improving health in the U.S. and globally, while the other half (48%) says the U.S. should spend its tax dollars on improving health in the U.S. only. The public is also largely split on whether more spending from the U.S. and other developed nations will lead to meaningful progress in improving health in developing countries.
  • Perceptions of progress. When asked how much progress has been made over the past five years broadly on global health, most people think that U.S. spending has made at least a small difference in the lives of individual people (82%) and in changing the overall course of disease (79%) in developing countries, though fewer say it has made a “big difference” on either dimension (34% and 26%, respectively).
  • Positive and negative news coverage matters. The survey finds a relationship between the media coverage that people report seeing and their perceptions of whether more global health spending will lead to progress. Among those who say they have seen mostly positive news stories about global health efforts, more than half (57%) say that more spending from the U.S. and other developed countries will lead to progress in improving health in developing countries. Among those who say they have seen mostly negative stories, 52% say more spending won’t make much difference.
  • Preferences for how aid is distributed. A strong majority of the public favors the U.S. giving money to international organizations like the Global Fund to Fight AIDS, Tuberculosis and Malaria (75%), and smaller majorities favor giving money to local non-profits (51%) and religious organizations (53%) working to improve health in developing countries. By contrast, seven in 10 say the U.S. should not give money directly to developing country governments, perhaps in part because corruption is the biggest perceived barrier to progress (eight in 10 say corruption and misuse of funds is a major barrier, and 53% say it is the most important barrier).
  • What kind of aid is most effective? By a 2-to-1 margin, the public thinks that money donated by individuals and charities is more likely than money donated by governments to reach the people who need it most. Interestingly, the public is as likely to incorrectly believe most aid for improving health comes from charities and individuals as to correctly say most comes from the U.S. government and other developed nation governments (46% each).
  • Challenges facing women. At a time when the U.S. government is increasingly focusing its international efforts on women and girls, eight in 10 people say that women in developing countries are worse off than men when it comes to their legal rights (81%) and ability to get a good education (78%). More than six in 10 also say women in developing countries are worse off than men in terms of their likelihood of living in poverty (66%) and their ability to get needed health care (61%).


The survey was designed and analyzed by the public opinion team at the Kaiser Family Foundation led by Mollyann Brodie, Ph.D., and including Liz Hamel, Carolina Gutierrez, and Theresa Boston. It was conducted August 3-16, 2010, among a nationally representative random sample of 1,213 adults ages 18 and older. Telephone interviews conducted by landline (812) and cell phone (401, including 185 who had no landline telephone) were carried out in English and Spanish. The margin of sampling error for the overall survey is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error may be higher. A report on the poll, along with full wording and results for all survey questions, can be viewed online at here.

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