Do Block Grant Resources Equitably Reach Rural Communities?  A 50 State Analysis

Authors' Affiliations

Margaret E Melton, Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN Michael Meit, Center for Rural Health Research, College of Public Health, East Tennessee State University, Johnson City, TN Casey Balio, Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN Kate Beatty, Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN Stephanie Mathis, Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN

Location

Culp Ballroom

Start Date

4-7-2022 9:00 AM

End Date

4-7-2022 12:00 PM

Poster Number

51

Faculty Sponsor’s Department

Health Services Management & Policy

Name of Project's Faculty Sponsor

Kate Beatty

Classification of First Author

Graduate Student-Doctoral

Competition Type

Competitive

Type

Poster Presentation

Project's Category

Rural Health

Abstract or Artist's Statement

Federal block grants are intended as non-competitive, formula grants mandated by the U.S. Congress that provide flexibility and increased capacity to state and local governments to provide services based on community need, including on such issues as social services and public health. It is unclear whether those resources are distributed in an equitable manner based on geography and other community characteristics. The population-based formulas that guide block grant distribution may make it difficult for sparsely populated states to distribute sufficient funds to less populated areas. Similarly, funding available through specific block grants may be insufficient to meet all community needs, placing rural communities at a disadvantage in resource prioritization. The purpose of the current study was to characterize distribution of five federal block grants to each of the 50 states based on state-level population and rurality. The study combined publicly available state-year-level data from 2018-2019 for all 50 states. Key data sources included funding amounts allocated to each state for selected block grant programs, American Community Survey data, and measures of rurality from the U.S. Census Bureau and the U.S. Department of Agriculture. Block grants considered included: 1) Preventive Health and Health Services (PHHS) Block Grant; 2) Community Services Block Grant (CSBG); 3) Child Care and Development Block Grant (CCDBG); 4) Substance Abuse Prevention and Treatment Block Grant (SABG); and 5) Community Mental Health Services Block Grant (MHBG). Analyses included descriptive statistics of distribution of block grants per 1,000 population and by three measures of state rurality. Mean funding amounts ranged from $614 per 1,000 to $5,562 per 1,000 people. Associations between measures of rurality and state block grant allocations were mixed in terms of direction and significance. For example, there was a significant positive relationship between percent of the population that lives in nonmetro counties and PHHS block grant allocations while there was a significant negative relationship between this measure of rurality and MHBG allocations. There was no significant relationship with the other three block grants. In contrast, there were significant positive associations between population density and allocation amounts for all block grants considered except for the CCDBG. Overall, our findings suggest that there are differences in how block grants are allocated to states based on their rurality both by the specific block grant and the measure of rurality considered. Importantly, these findings only assess state-level allocations based on state-level characteristics and do not directly measure amounts of funding that make it to rural communities within states. Findings provide insight on the implications of different block grant formulas and structures.

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Apr 7th, 9:00 AM Apr 7th, 12:00 PM

Do Block Grant Resources Equitably Reach Rural Communities?  A 50 State Analysis

Culp Ballroom

Federal block grants are intended as non-competitive, formula grants mandated by the U.S. Congress that provide flexibility and increased capacity to state and local governments to provide services based on community need, including on such issues as social services and public health. It is unclear whether those resources are distributed in an equitable manner based on geography and other community characteristics. The population-based formulas that guide block grant distribution may make it difficult for sparsely populated states to distribute sufficient funds to less populated areas. Similarly, funding available through specific block grants may be insufficient to meet all community needs, placing rural communities at a disadvantage in resource prioritization. The purpose of the current study was to characterize distribution of five federal block grants to each of the 50 states based on state-level population and rurality. The study combined publicly available state-year-level data from 2018-2019 for all 50 states. Key data sources included funding amounts allocated to each state for selected block grant programs, American Community Survey data, and measures of rurality from the U.S. Census Bureau and the U.S. Department of Agriculture. Block grants considered included: 1) Preventive Health and Health Services (PHHS) Block Grant; 2) Community Services Block Grant (CSBG); 3) Child Care and Development Block Grant (CCDBG); 4) Substance Abuse Prevention and Treatment Block Grant (SABG); and 5) Community Mental Health Services Block Grant (MHBG). Analyses included descriptive statistics of distribution of block grants per 1,000 population and by three measures of state rurality. Mean funding amounts ranged from $614 per 1,000 to $5,562 per 1,000 people. Associations between measures of rurality and state block grant allocations were mixed in terms of direction and significance. For example, there was a significant positive relationship between percent of the population that lives in nonmetro counties and PHHS block grant allocations while there was a significant negative relationship between this measure of rurality and MHBG allocations. There was no significant relationship with the other three block grants. In contrast, there were significant positive associations between population density and allocation amounts for all block grants considered except for the CCDBG. Overall, our findings suggest that there are differences in how block grants are allocated to states based on their rurality both by the specific block grant and the measure of rurality considered. Importantly, these findings only assess state-level allocations based on state-level characteristics and do not directly measure amounts of funding that make it to rural communities within states. Findings provide insight on the implications of different block grant formulas and structures.