Distributing Local Resources for Public Health Preparedness Grants: A Data-Driven Approach

Area of Science:

• Public Health
• Health Services Research
• Health Policy

Background:

• Current Public Health Emergency Preparedness (PHEP) fund allocations often rely on population-based metrics, potentially overlooking critical dimensions of community need.
• The equitable distribution of PHEP funds is crucial for ensuring preparedness across diverse county-level contexts.

Purpose of the Study:

• To simulate PHEP fund allocations to counties using alternative metrics of need, minimum allocation amounts, and discretionary funding proportions.
• To assess the impact of incorporating a community resilience index into PHEP funding formulas.

Main Methods:

• Developed a county-level community resilience index for 57 New York State counties using publicly available indicators.
• Created an interactive spreadsheet model with 8 hypothetical allocation formulas combining population size, resilience index (and its domains), and population density.
• Compared simulated allocations with the 2013-2014 fiscal year PHEP grant allocation.

Main Results:

• Simulations showed significant variations in PHEP allocations compared to the existing model ($6.27 million total for New York counties outside NYC).
• Sparsely populated counties receiving minimum allocations ($50,825) experienced the largest changes under alternative strategies.
• Allocation outcomes were sensitive to minimum allocation amounts, discretionary funding proportions, and the specific need indicators used.

Conclusions:

• Population-based allocation methods may not fully capture the complex needs of communities.
• Integrating robust local community resilience measures into PHEP funding formulas is feasible.
• Interactive spreadsheet models can empower stakeholders to evaluate and understand the implications of different funding strategies.