A Rural Lens on Federal Block Grant Distribution

View Policy Brief

09/2025

Block grant funding is used across federal agencies, including in the areas of public health and social services. This multi-pronged qualitative study uses document review and interviews with key informants from federal agencies responsible for administering five block grants across three agencies. Based on study findings, researchers identify potential opportunities to improve consideration of rurality within block grant allocation processes, such as exploring the role of rural carve-outs and encouraging collaboration with rural partners.

Key Findings:

• Funding formulas are complex, challenging to change, and often based on historical funding levels.
• Rurality is often not explicitly considered in block grant formulas and state allocations.
• The goals or intended outcomes vary by block grant and were generally described as broad and flexible, allowing states and local entities to adjust their activities to meet program goals.

ETSU/NORC Rural Health Research Center

Casey Balio, Stephanie Mathis, Margaret Francisco, Michael Meit, Kate Beatty

Healthcare financing, Poverty, Public health, Social determinants of health, Substance use and treatment