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APHA Scientific Session and Event Listing

Recorded presentation

Lorraine R. Ettaro, PhD, MPH¹, Leigh Ann White, PhD², Tiffany Fitzpatrick, BA³, Michael Meit, MA, MPH¹, Lauren Silver, BA², Benjamin Hamlin, MPH², and Bhumika Piya². (1) Center for Rural Health Practice, University of Pittsburgh, 300 Campus Drive, Bradford, PA 16701, 814-362-5047, lrest3@pitt.edu, (2) Walsh Center for Rural Health Analysis, NORC at the University of Chicago, 7500 Old Georgetown Road, Suite 620, Bethesda, MD 20814, (3) Center for Public Health Practice, University of Pittsburgh Graduate School of Public Health, Forbes-Allies Center, Suite 210, 3109 Forbes Avenue, Pittsburgh, PA 15260

Changing national objectives and regional variations in financing influence the ability of rural communities to conduct public health functions. This paper, submitted as part of the proposed public health financing session, investigates how federal funds for selected chronic disease prevention activities are applied locally. A central hypothesis is that federal funding for chronic disease prevention reaches communities having the infrastructure to support initiatives. We explore the relationship between elements of public health infrastructure and funding for selected chronic disease prevention activities through a 50-state analysis augmented by in-depth case studies. The 50-state profile examines: characteristics of state-local public health infrastructure (e.g., governance, jurisdictional information, workforce, access to resources); indicators, including rural/urban comparisons, from the National Association of County and City Health Officials 2005 National Profile of Local Health Departments; and 2004-05 state level CDC funding. Building on this profile and findings from a previous qualitative study of public health infrastructure, we develop detailed case profiles of six states. To explore which aspects of state and local public health infrastructure facilitate funding for prevention programs in communities, we use semi-structured telephone interviews to query state and local public health representatives in these states about the management, distribution, and use of funds for select chronic disease prevention activities. Findings provide valuable information about the distribution of federal chronic disease prevention funds to local communities, and highlight important systems and financing issues that may pose barriers to implementing public health activities in chronic disease prevention in rural localities.

Learning Objectives:

• Describe how CDC funds for chronic disease prevention programs are used by states and local communities.
• Identify public health infrastructure-related barriers that communities may face in securing and using funds for chronic disease prevention programs. 3.Identify aspects of state and local public health infrastructure that facilitate funding for chronic disease prevention programs in rural communities.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation