The Centers for Disease Control and Prevention (CDC) has announced the availability of funding for its Community Transformation Grants. This long-awaited announcement implements one of the key community-level prevention activities included in the Patient Protection and Affordable Care Act, enacted over a year ago.
The purpose of the initiative is to create healthier communities by focusing on capacity building and implementation of broad, evidence-based and practice-based policy, environmental, programmatic, and infrastructure changes. The overall long-term goal of the initiative is to achieve reductions in death or disability from the leading causes of death in the United States and specifically to demonstrate changes in: weight, proper nutrition, physical activity, tobacco use, and emotional wellbeing and overall mental health.
The total amount of funding available for awards this fiscal year is $102 million. Projects may be funded for up to five years. The approximate amount of funding for the five-year project period is $900 million. These amounts are estimates and are subject to availability of funds. The CDC estimates that up to 75 awardees will receive funds this fiscal year. Applications are due on July 15, 2011. Funds will be awarded on or before September 30, 2011.
Funding is available for multi-sectoral coalitions to address community health issues and health disparities. A multi-sectoral coalition is a coalition consisting of a broad range of professionals and community members, representing different occupational/interest groups or economic sections of society working together to achieve a common goal. A multi-sectoral coalition should represent the disciplines, agencies, organizations, and populations with an interest or stake in the proposed policy, environmental, programmatic, and infrastructure changes. Specifically, these changes include these activities:
- Policy: Educate the public and stakeholders about evidence-and practice-based policy intervention to improve population health and foster healthy behaviors.
- Environment: Create social and physical environments that support healthy living and ensure that healthy choices are the easy choice.
- Programmatic Changes: Increase access to prevention programs to support healthy choices and contribute to wellness, ensuring integration of their use in a variety of community and clinical settings (e.g., schools, community recreation centers, Federally Qualified Health Centers [FQHCs] and workplaces).
- Infrastructure Changes: Establish systems, procedures, and protocols within communities, institutions, and networks that support health behaviors. This includes improving linkages between public health and health care systems.
One of the overarching Healthy People 2020 goals, “achieve health equity, eliminate health disparities, and improve the health of all groups,” is central to Community Transformation Grants. Health disparities represent preventable differences in the burden of disease, disability, injury and violence, or in opportunities to achieve optimal health. Recipients will engage populations facing health disparities where they live, study, work, play, seek healthcare, and age to make the healthy choice the easy choice, and assure equitable opportunities to make healthful choices. All activities supported through this initiative must be designed to either achieve, or build community capacity to achieve, area-wide health improvements and reductions in health disparities. Activities should be based on a robust analysis of area health burden overall and across population subgroups (population subgroups may be defined by factors such as race or ethnicity, gender, age (e.g., youth, the elderly), education or income, disability, geographic location, or sexual orientation, among others) to establish a baseline from which to measure progress.
To advance health equity, funded projects have to ensure staff have experience and/or training regarding health equity, conduct assessments and identify population subgroups experiencing health disparities; ensure plans and strategies are explicitly linked to population subgroups experiencing health disparities; and ensure that both leadership team and coalition partners include representatives from those identified population subgroups. Additionally, funded partners must actively engage population subgroups experiencing health disparities to understand potential barriers to and needs of population subgroups for policy, environmental, programmatic, and infrastructure changes; and identify appropriate strategies for overcoming these barriers and ensuring effective and equitable policy, environmental, programmatic, and infrastructure strategies and implementation. These efforts will help recipients ensure that planning and implementation activities reach the entire population and specific population subgroups, identified by the applicant, with documented health disparities within the geographic area. Not only is health equity critical to the staffing, partnership, planning and implementation components of the program, the initiative includes requirements for monitoring and evaluation of those efforts to understand the impact of this work on health disparities and build the evidence-base. Successful applicants will be required to identify population subgroups experiencing health disparities, select population subgroups to address, and identify specific outcomes to narrow gaps. Applicants will be accountable for both population-wide improvement and narrowing of specific gap(s) in health outcomes.
Ignatius Bau 