Changing national policy combined with state and local variation in the distribution of funds for chronic disease prevention and health promotion can influence the ability of rural communities to conduct public health functions that address specific objectives.

With funding from the federal Office of Rural Health Policy (ORHP), researchers from the NORC Walsh Center for Rural Health Analysis and the Center for Rural Health Practice at the University of Pittsburgh (Bradford, PA) investigated how federal and state funds for chronic disease prevention are applied at the local level. The purpose of this study was to describe the federal-state funding streams for selected local public health activities in the areas of chronic disease prevention and health promotion, and assess potential barriers to program implementation in less populated, rural areas of a state. The research sought to address deficits in understanding related to how federal and state funds for particular public health objectives are being used by localities, particularly in rural communities where disparities in health risks such as smoking and obesity may be marked.

Through a quantitative analysis of funding streams across all 50 states and a qualitative analysis conducted through interviews with key informants in six states, this work examined the availability of funding and organizational mechanisms by which localities receive funding for selected population-based chronic disease prevention and health promotion activities. The study expanded on prior qualitative research which yielded case studies of six states' public health infrastructure and addressed a broader aim of describing how differences in state public health infrastructure influence the provision of public health activities in rural communities.

Publications

• Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
  NORC Walsh Center for Rural Health Analysis
  Date: 06/2008
  This is the final report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state- and local-level public health infrastructure.
• Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding
  Policy Brief
  NORC Walsh Center for Rural Health Analysis
  Date: 06/2008
  This study's purpose was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes.