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Distributing Local Resources for Public Health Preparedness Grants

A Data-Driven Approach

Zamboni, Lucila M. PhD, MPP; Martin, Erika G. PhD, MPH

Journal of Public Health Management and Practice: February 14, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHH.0000000000000824
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Objectives: To simulate allocations of Public Health Emergency Preparedness funds to counties using alternative metrics of need, minimum allocation amounts, and the proportion earmarked for discretionary considerations.

Design: We developed a county-level community resilience index of 57 New York State counties using publicly available indicators, which we incorporated into an interactive spreadsheet of 8 hypothetical allocation formulas with different combinations of population size, the index and its 5 domains, and population density. Simulations were compared with the 2013-2014 fiscal year grant allocation.

Results: New York allocated $6.27 million to counties outside New York City, with a median allocation of $78 038, ranging from $50 825 to $556 789. These allocations would vary under different strategies, with the largest changes among sparsely populated counties that currently receive a minimum allocation of $50 825. Allocations were sensitive to changes in minimum allocation, amount earmarked for discretionary allocation, and need indicator.

Conclusions: Population-based approaches are commonly used but ignore important dimensions of need. It is feasible to include robust local community resilience measures in formulas, and interactive spreadsheet models can help stakeholders evaluate the consequences of alternative funding strategies.

New York State Department of Health, Albany, NY (Dr Zamboni); and Rockefeller College of Public Affairs and Policy, University at Albany (SUNY), Albany, New York (Dr Martin).

Correspondence: Lucila M. Zamboni, PhD, MPP, New York State Department of Health, Corning Tower, Room 1072, Albany, NY, 12237 (Lucila.Zamboni@health.ny.gov).

The authors extend their gratitude to Brian Nussbaum and Patricia Strach for their comments and suggestions that greatly improved this study.

Opinions expressed by the authors do not represent the opinion of the New York State Department of Health.

The authors declare no conflicts of interest.

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