general_story

An image of loose US bills and surgical masks.

The US Public Health System has a long-standing history of underinvestment, leading to a reduction in quality of life for individuals and communities. ¹

An ill-equipped, under-resourced health department cannot function effectively.

This leads to slow disease tracking allowing disease like foodborne illness to spread faster; and costly chronic disease management that could have been prevented.

Agencies require flexibility to tackle unique and emerging public health problems including investment in public health infrastructure and capacity.

These investments enable health departments to provide essential public health services and to respond to emergencies so that communities can thrive.

An illustrated gif of an orange speech bubble with three exclamation points that appear inside it. An illustrated orange speech bubble with three exclamation points inside it.

However, categorical grants make up the majority of federal funds distributed to state and local government.²

The PHHS Block Grant is a longstanding flexible funding source that allows recipients to meet their prioritized needs.

For more than 40 years, the Preventive Health and Health Services Block Grant has served as an essential funding source for state, tribal, territorial, and freely associated state health agencies.

The consistency and sustainability of this grant funding allow recipients to initiate, expand, maintain, and sustain progress on initiatives that complement categorical funding and build a more robust public health infrastructure.

The PHHS Block Grant provides funding to:³

All 50 States +

District of Columbia

2 American Indian Tribes

5 US territories

3 Freely associated states

Recipient Reflections

An illustrated gif where a speech bubble with a quote appears it reads: “the nature of the block grant dollars themselves is [to be] a facilitator.” An illustrated orange speech bubble that reads: “the nature of the block grant dollars themselves is [to be] a facilitator.”

^{—PHHS Block Grant Coordinator, 2022}

An illustrated gif where a speech bubble with a quote appears it reads: “…we [have] more flexibility to use these dollars as needed as opposed to a scripted program... We have the ability to use block grant dollars have more flexibility.”

An illustrated speech bubble with a quote that reads: “…we [have] more flexibility to use these dollars as needed as opposed to a scripted program... We have the ability to use block grant dollars have more flexibility.”

^{—PHHS Block Grant Coordinator, 2022}

Recipients, in collaboration with their advisory committees, use the PHHS Block Grant to address unfunded or underfunded programs that focus on the leading causes of death and disability.

The PHHS Block Grant allows recipients to identify and fund initiatives aligned with national Healthy People objectives that address vital community public health needs in a way that categorical funding may not be equipped to support.

An illustrated gif that shows animated blocks labelled 'categorical' being stacked up and connected with a trowel of "PHHS Mortar" from a bucket. It ends with an unstable wobbling categorical block falling and cracking when it lands at the top, and then the crack is filled with mortar. An illustrated image that shows a stack of bricks labelled 'categorical' that are connected with a trowel of "PHHS Mortar" from a bucket. The top brick on the stack has a crack in it that has also been filled with the mortar.

Recipient Reflections

A mother in a hijab and a father in a kitchen, with their child sitting on the counter. They are all smiling and child is handing the mother a tomato. There is a bowl of tomatoes and a bowl of greens that the mother is handling.

“[T]he block grant gave us some stability… to fully – or more fully – address the needs of families [in our jurisdiction]”

_{— PHHS Block Grant Coordinator, 2023}

Recipient Reflections

Two multiethnic friends in white kn95 masks walking their bikes near trees.

“By definition, the block grant fund gives the recipient ability to address [and] prioritize public health needs in their jurisdiction. [We are able to] set our own goals and … implement the local strategy to address national health priorities, [such as] the response to COVID-19 pandemic.”

_{— PHHS Block Grant Coordinator, 2022}

In FY 21 - 22, recipients (58%) used PHHS Block Grant funds to address emerging public health needs.⁴

Emerging needs over the past few years have included immunization and infectious diseases and social determinants of health.

118 emerging public health needs were addressed with the PHHS Block Grant in FY 21 – 22.⁵

How Emerging Public Health Needs were Addressed in FY 21 - 22 | n = 118 ⁶

Nearly all recipients (94%) used grant funds to implement public health programs, services, or policies, most of which were evidence based (moderate, strong, or rigorous).⁷

Of the 947 public health interventions that recipients implemented in FY 21 – 22,
776 (82%) were evidence based.⁸

The top 5 health topic areas made up 58% of the 776 total evidence based interventions.⁹

An illustrated gif of a seed sprouting. An illustration of a seed sprouting.

In some cases, this grant serves as “seed funding” for innovative projects that a state, tribal, territorial, or freely associated state health agency provides to meet otherwise-unfunded community health goals.

It allows recipients to try intentional, innovative ideas, while remaining good stewards of federal funds.

Wait— what is innovation?

A gif of an illustrated light bulb turning on and shining brightly to represent "innovation". An illustrated light bulb shining brightly to represent "innovation".

The creation and implementation of a novel process, policy, product, program, or system leading to improvements that impact health and equity. It is a new or adapted solution that may be creative, untested and based on context.

Successful innovation results in improved effectiveness, efficiency, or quality.

The process of innovating, through successes and failures, will produce new learning and understanding for informed decision-making and program improvement.¹⁰

The PHHS Block Grant also allows recipients to be innovative and find solutions that meet their community’s needs.

Within FY 21 – 22 some recipients leveraged PHHS Block Grant funding to implement untested, innovative and/or new public health interventions.

Of the 43 interventions with a weak or no evidence base, 63% were untested, innovative, and/or new.¹¹

Innovation as a concept pushes the field to think of new and different ways of addressing challenges to help meet community needs.

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Depending on the need, evidence-based interventions may not exist.

Innovation allows for jurisdictions to balance the current evidence-base with what they hear from their communities.

Often this form of customization isn’t feasible within the structure of categorical funding.

The flexibility of the PHHS Block Grant Funds to meeting emerging needs allows recipients to build the evidence-base. In FY 21 - 22, 65% of the 43 interventions with a limited evidence base collected new data as a result.¹²

“[Block grant funding] really helped us … increase our statistical power and our ability to represent diverse populations on that first as well as all of our subsequent surveys heading into the three years of data collection.”

^{—PHHS Block Grant Coordinator, 2022}

Recipient Reflections

An illustrated gif where a speech bubble with a quote appears. It reads: "“We love it when we have ...the opportunity to be innovative, then tailor work to the needs of the community as described by the community.” An illustration of a speech bubble with a quote that reads: "“We love it when we have ...the opportunity to be innovative, then tailor work to the needs of the community as described by the community.”

^{—PHHS Block Grant Coordinator, 2023}

An illustrated gif where a speech bubble with a quote appears. It reads: “Using this funding for stuff that’s dynamic that starts to really show off the importance and the benefit that the block grant funding really has.”

An illustration of a speech bubble with a quote that reads: “Using this funding for stuff that’s dynamic that starts to really show off the importance and the benefit that the block grant funding really has.”

^{—PHHS Block Grant Coordinator, 2023}

Overall recipients utilize the PHHS Block Grant to:

Expand existing programs that are effective and have the biggest impact within the jurisdiction.

Implement programs that are needed for new, unexpected crises.

Achieve state, territorial, and tribal health goals and objectives.

Implement evidence-based programs for the categories that aren’t discretely funded elsewhere.

Try innovative programs that lack categorical funding because they don’t exist yet or because they aren’t “evidence-based/informed” within the public health sector.

Topics addressed by the PHHS Block Grant include:¹³

Thanks for reading!

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You can read more stories about how recipients use the PHHS Block Grant for Innovation, Growth, Community Needs, and Meeting Needs at the links on this webpage.

Public health funding is insufficient

The PHHS Block Grant is a longstanding flexible funding source that allows recipients to meet their prioritized needs.

The PHHS Block Grant provides funding to:³

Recipient Reflections

Recipient Reflections

Recipient Reflections

Wait— what is innovation?

The PHHS Block Grant also allows recipients to be innovative and find solutions that meet their community’s needs.

Innovation as a concept pushes the field to think of new and different ways of addressing challenges to help meet community needs.

Recipient Reflections

Overall recipients utilize the PHHS Block Grant to:

Topics addressed by the PHHS Block Grant include:¹³

You can read more stories about how recipients use the PHHS Block Grant for Innovation, Growth, Community Needs, and Meeting Needs at the links on this webpage.

Footnotes