The COVID-19 pandemic has highlighted troubling disparities in health access and outcomes for vulnerable populations. The high case incidence of COVID-19 in rural areas has had severe consequences for mortality. In addition to lower vaccination rates, this high rural mortality has been attributed to unique characteristics of the population in rural America as well as the limited public health and hospital infrastructure in rural communities. The Centers for Disease Control (CDC), in 2021, carved out $427 million in state funding to focus on combatting COVID-19 in rural communities as part of a multi-billion dollar national initiative to address COVID-19 related health disparities among at risk and underserved populations.

This project was designed to understand the circumstances around this unprecedented emphasis on rural America in the CDC's key initiatives. To do so, relevant decision-makers, key actors and stakeholders were interviewed. The analysis provided critical insight into the evolving relationship between the Federal Office of Rural Health Policy and the CDC over time, lessons learned from this particular grant program, and how those lessons might be able to be applied to future efforts to carve out rural-focused funds from broader grant projects.

Publications

• Analysis of an Innovative Approach to Target Rural Communities in Public Health Funding
  Policy Brief
  Southwest Rural Health Research Center
  Date: 03/2023
  The CDC launched a new initiative to address COVID-19 related health disparities and to advance health equity among underserved and at-risk populations. Based on stakeholder interviews, this project explores the formation of this initiative, its impact on rural health, and lessons learned that can be applied to future rural-focused funds.
• Opportunities and Challenges of Using Carve-Outs to Fund Rural Public Health Initiatives: Evidence From the COVID-19 Pandemic
  Journal Article
  Southwest Rural Health Research Center
  Date: 06/2023
  This project explores the impact and lessons learned from the first large-scale rural carve out of a CDC funding initiative. Based on stakeholder interviews, our analysis found they supported this funding mechanism and that the funds were being used in interesting and creative ways.