Flexibility of PHHS Block Grant Supports Health Equity in Communities

December 18, 2023 | Cendra Clarke

With a continued focus on health equity and social determinants of health, health agencies require a funding infrastructure that allows them to address their needs through a variety of initiatives. Fortunately, the Preventive Health and Health Services (PHHS) Block Grant is a flexible funding source, making it a prime funding mechanism that jurisdictions can and should take advantage of to meet community needs.

PHHS Block Grant Aiding Community-Driven Health Equity Initiatives

Often, categorical funding limits a jurisdiction’s ability to work in innovative ways or with non-traditional partners. Flexible funding, however, can support these efforts where it is beneficial for jurisdictions to work in a non-traditional way to create meaningful progress towards community outcomes.

The PHHS Block Grant allows recipients to identify and fund initiatives that address vital community public health needs in a way that categorical funding may not be equipped to support. When assessing how recipients are using the PHHS Block Grant through a measures assessment, CDC found that among respondents, social determinants of health was a top emerging need that health agencies are utilizing the PHHS Block Grant funds to address.

There is no one-size-fits-all approach to addressing health equity. Based on community needs and capacity, health agencies can take a variety of approaches to implementing health equity strategies. For some jurisdictions, their needs may lie in addressing day-to-day challenges (e.g., ensuring water quality and access to health services). Other jurisdictions may have the opportunity to make policy and organizational changes to support this work. Whatever the approach, the PHHS Block Grant’s flexibility can support jurisdictions’ ability to meet their priorities and respond to community needs.

Jurisdictions Are Using the PHHS Block Grant Creatively

ASTHO and CDC have learned about a variety of ways recipients use the PHHS Block Grant to support social determinants of health and health equity initiatives.

Guam: Diabetes Health Screening

The PHHS Block Grant has been instrumental for the Guam Department of Public Health and Social Services in creating opportunities that address categorical funding limits. The health agency used PHHS Block Grant funding to supplement their diabetes program and procure resources for health screenings, which allowed them to deliver necessary supplies to a broader group (e.g., blood glucose meters, test strips, lancing device kits, lancets, and body composition monitors with scales). The funding supported the agency’s goal of engaging and serving their underserved communities.

Idaho: Get Healthy Idaho Initiative

Get Healthy Idaho is an initiative born out of the Idaho Department of Health and Welfare’s statewide health improvement plan, focused on “investing in place-based community-led collaboratives with the goal of advancing equity within communities.” This initiative allows for the communities to decide how to best create innovative solutions for their needs. The Idaho Department of Health and Welfare utilized the flexibility of the PHHS Block Grant to support these communities, allowing them to maintain fidelity to health equity by advancing solutions that are led by the communities they aim to help.

Massachusetts: Mass in Motion Program

Started in 2009, Mass in Motion is a statewide initiative led by the Massachusetts Department of Public Health that empowers local agencies collaborating with community-based organizations to make policy and practice changes, fostering healthy eating and active lifestyles for residents. Predominantly funded by the PHHS Block Grant, the initiative engages and supports local communities through direct funding and technical assistance.

The PHHS Block Grant’s flexibility has allowed Massachusetts to deepen the program’s focus on equity, using policy, system, and environmental changes to address root causes of health inequities. With this enhanced emphasis, the department strengthened the requirement for community grantees to partner with people with lived experience and provided technical assistance to ensure residents were authentically engaged at leadership and decision-making tables for community initiatives.

Michigan: Young Fatherhood Initiative

For Michigan’s Department of Health and Human Services, the PHHS Block Grant has funded initiatives that are important to community members. In recognizing the need for added support for young fathers across Michigan, high-need communities began delivering father-focused programming tailored towards reducing unintended repeat teen pregnancy and improving father involvement.

With support from the PHHS Block Grant and the health agency listening to community needs, the Young Fatherhood Initiative has served more than 100 young fathers through strength-based case management and support services. This is an evidence-based intervention, supported by Son to a Father, that provides a unique platform for young fathers to unpack their personal experiences with fatherhood, including challenging definitions of masculinity and establishing the role they want to play in their child’s life.

Using the PHHS Block Grant in Your Community

Some recipients may be interested in utilizing the PHHS Block Grant to support a health equity initiative but do not know where to start. Here are a few things to consider as you think about how the PHHS Block Grant can support your ability to meet your community’s needs:

• Be intentional about addressing health disparities and utilize data to better understand what disparities exist.
• Engage with impacted communities throughout the lifespan of initiative, from conception to implementation and evaluation. Consider training and including community members in collaboratives or advisory groups as well as funding sub-recipients.
• Chat with your CDC PHHS Block Grant program officer about how to create broader buckets in your workplans that will allow you to be flexible in addressing community needs as you discover them.
• Assess how the PHHS Block Grant can support your agency’s broader health equity goals in a way that complements categorical funding efforts.
• Create a sustainability plan for your health equity work. This may include leveraging the PHHS Block Grant funds towards other funding mechanisms to continue or expand on the initiative.

Learn more about how recipients are using the PHHS Block Grant to tackle factors influencing health disparities in the CDC/ASTHO report “Exploring how PHHS Block Grant recipients use funds to address social determinants of health and advance health equity” and how recipients have used the PHHS Block Grant to implement innovative solutions in the ASTHOReport “Flexible Funding to Support Public Health Innovation.”