Federal funding, including through block grants, provides states with considerable flexibility in allocating funds. States therefore allocate these funds in a variety of ways and based on different factors, including recently popularized area-level measures such as the Social Vulnerability Index (SVI), and measures of population size, poverty, and rurality.

The purpose of this study is to model how funding formula structures within states affect allocation amounts to counties overall and by county-level measures of rurality, race, and ethnicity. This national study will focus on examples of Centers for Disease Control and Prevention (CDC) funding and area-level indices (SVI and Minority Health SVI) to model the impact of different formulas within real-world funding mechanisms. The CDC's Public Health Infrastructure Grant and the COVID-19 Health Disparities grant will be used as example funding mechanisms. These were selected as they are large, recent federal grants allocated to at least all states, one of which includes a rural carve-out (COVID-19 Health Disparities) and one of which does not. Modeling of formulas within these existing funding mechanisms is designed to provide states with examples of different formula structures and what the implications are for rural communities, and by county-level racial and ethnic composition. Findings from this study are designed to identify how potential funding formulas and structures affect allocations by state and community characteristics, which may inform federal and state guidance regarding formulas and resource allocations.