PHIG: A Transformative Infrastructure Grant for Health Equity and Inclusive Workforces

May 14, 2024 | Amber Williams, Lindsey Myers

Following the COVID-19 pandemic, Congress made a historic investment in public health workforce and infrastructure, presenting a game-changing opportunity for public health transformation. In the fall of 2022, CDC rolled out a first of its kind, five-year grant program called the Public Health Infrastructure Grant (PHIG) to address critical governmental public health workforce and system improvement needs. This program is all about supporting health departments across our states, territories, and freely associated states to ensure every community has the people, services, and systems needed to promote and protect optimal health for all.

Along with funding 107 health departments, CDC also partnered with three organizations: the Association of State and Territorial Health Officials, the National Network of Public Health Institutes, and the Public Health Accreditation Board to help agencies modernize data systems, recruit and retain a skilled public health workforce, and address longstanding public health infrastructure needs.

Challenges in Public Health Funding and the Pivotal Introduction of PHIG

The majority of public health department funding comes from topic-specific federal grants, which usually restrict spending to prescribed programmatic activities and do not allow agencies to build foundational capabilities—like improving hiring or procurement processes, communication, and community engagement.

For example, while advancing health equity and addressing health disparities is often emphasized as a central goal of public health practice, many jurisdictions face barriers to fully incorporating health equity into their strategies. Additionally, the public health workforce often does not reflect the communities they serve, which can impact their ability to build community partnerships and fully respond to the needs of underserved populations.

PHIG is different in that it provides flexible, non-categorical funding that health departments can use to build their infrastructure and capacity to meet their unique needs and address barriers.

PHIG Impact: Advancing Health Equity and Promoting Inclusion in Public Health Agencies

Many agencies are using their PHIG funding to boost efforts to tackle health disparities in their jurisdictions and promote diversity, equity, and inclusion within their agencies. Internally they are focusing on examining compensation, assessing equitable pay, developing leadership programs for staff of color, streamlining hiring processes, and assuring unbiased hiring practices.

Some agencies are creating paid internships, hiring people with lived experience, and building new workforce pipelines through engagements with minority-serving educational institutions. Plus, they are training managers and staff to create more inclusive workplace environments and partner with and serve diverse communities better. Other approaches include:

• Taking lessons learned from other funded programs, such as the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant, to focus and build on successes.
• Strengthening the overall capacity of the agency to address health equity, such as by incorporating health equity into agency-wide performance improvement offices and ensuring equity principles are embedded in health assessments and strategic plans.
• Improving partnerships with community organizations—looking at opportunities to simplify processes; support minority-owned institutions in competing for and managing federal funding; and hiring new staff dedicated to health equity, liaisons with special populations including tribes, and community health workers.

This is a remarkable time for public health. Improving public health infrastructure and strengthening the workforce will lead to better health outcomes for all. These grants are critical, providing much-needed funding and flexibility to make real progress in promoting diversity, equity, and inclusion in the workforce and ensuring health equity in public health strategies.

This first appeared in the Diverse Executives Leading in Public Health (DELPH) Magazine, Issue 3. Learn more about DELPH’s leadership development initiative by visiting the DELPH program page.