State Priorities and Needs: The Role of Block Grants

被引:1
作者
Balio, Casey P. [1 ,2 ,3 ]
Mathis, Stephanie M. [1 ,2 ,4 ]
Francisco, Margaret M. [1 ,2 ,4 ]
Meit, Michael [1 ,2 ,3 ]
Beatty, Kate E. [1 ,2 ,3 ]
机构
[1] East Tennessee State Univ, NORC Rural Hlth Equ Res Ctr, Johnson City, TN 37604 USA
[2] East Tennessee State Univ, Ctr Rural Hlth Res, 2109 W Market St,Off 116, Johnson City, TN 37604 USA
[3] East Tennessee State Univ, Dept Hlth Serv Management & Policy, Johnson City, TN 37604 USA
[4] East Tennessee State Univ, Dept Community & Behav Hlth, Johnson City, TN 37604 USA
关键词
rural health; block grants; public health; health policy; financing;
D O I
10.1177/00333549231205338
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objectives: Block grant funding provides federal financial support to states, with increased flexibility as to how those funds can be allocated at the community level. At the state level, block grant amounts and distributions are often based on outdated formulas that consider population measures and funding environments at the time of their creation. We describe variation in state-level funding allocations for 5 federal block grant programs and the extent to which funding aligns with the current needs of state populations. Methods: We conducted an analysis in 2022 of state block grant allocations as a function of state-level characteristics for 2015-2019 for all 50 states. We provide descriptive statistics of state block grant allocations and multivariate regression models for each program. Models include base characteristics relevant across programs plus supplemental characteristics based on program-specific goals and state population needs. Results: Mean state block grant allocations per 1000 population by program ranged from $618 to $21 528 during 20152019. Characteristics associated with state allocations varied across block grants. For example, for every 1-percentage-point increase in the percentage of the population living in nonmetropolitan areas, Preventive Health and Health Services Block Grant funding was approximately $7 per 1000 population higher and Community Services Block Grant funding was approximately $40 per 1000 population higher. Few supplemental characteristics were associated with allocations. Conclusions: Current block grant funding does not align with state characteristics and needs. Future research should consider how funds are used at the state level or allocated to local agencies or organizations and compare state block grant allocations with other types of funding mechanisms, such as categorical funding.
引用
收藏
页码:451 / 457
页数:7
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