Community Transformation Grants to Reduce Chronic Disease

The Affordable Care Act created Community Transformation Grants aimed at helping communities implement projects proven to reduce chronic diseases – such as diabetes and heart disease. By promoting healthy lifestyles and communities nationwide, especially among population groups experiencing the greatest burden of chronic disease, these grants will help improve health, reduce health disparities, and lower health care costs.

The Cost of Chronic Disease & the Need for Prevention

Chronic diseases – such as heart disease, cancer, stroke, and diabetes – are responsible for 7 of 10 deaths among Americans each year. Treatment for people with chronic conditions account for more than 75 percent of the more than $2 trillion spent on annual U.S. medical care costs. Obesity is a significant health care cost driver – in 2008, about $147 billion of medical bills were weight-related. With disease risk often related to economic, social, and physical factors, too many people engage in behaviors – such as tobacco use, poor diet, physical inactivity, and alcohol abuse – that lead to poor health and contribute to chronic disease.

Implementing and expanding evidence-based prevention will offer our nation the opportunity to not only improve the health of Americans, but also control health care spending. A report from Trust for America’s Health, Prevention for a Healthier America, concluded that investing $10 per person per year in proven community-based programs that increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within 5 years.

Community Transformation Grants: Building on Success

Community Transformation Grants will help States, local governments, Tribes, and Territories use evidence-based strategies to address the challenges of chronic diseases and health disparities.

Community Transformation Grants will support prevention programs in up to 75 communities across the country over the next five years, with projects expanding their scope and reach over time as Federal resources permit. State and local government agencies, tribes and territories, and State or local non-profit organizations are eligible to apply. At least 20 percent of grant funds will be directed to rural and frontier areas.

Consistent with the law, the grants will focus on five priority areas: 1) tobacco-free living; 2) active living and healthy eating; 3) evidence-based quality clinical and other preventive services, specifically prevention and control of high blood pressure and high cholesterol; 4) social and emotional wellness, such as facilitating early identification of mental health needs and access to quality services, especially for people with chronic conditions; and 5) healthy and safe physical environments.

These projects will build on the successes and lessons learned through programs that have been proven to work. Some of the types of efforts that have been proven successful are:

  • Reducing Type 2 Diabetes: Currently, 1 out of every 9 American adults – more than 25 million people – has diabetes. Another 79 million – 35 percent of adults – have prediabetes, a condition that raises the risk of developing type 2 diabetes, heart disease, and stroke. Diabetes is the seventh-leading cause of death in America and can cause a number of serious health complications, including heart disease, kidney failure, blindness, nerve damage and amputation of feet and legs. Excess medical costs due to diabetes amount to $6,600 per person annually. A clinical trial conducted by the NIH and CDC found that lifestyle changes in diet and exercise can prevent or delay type 2 diabetes in those with prediabetes. People who made these lifestyle changes reduced their risk of getting type 2 diabetes by 58 percent, an effect seen across all ages and ethnic groups. Real-world programs, offered in a group setting, showed similar results for an annual cost of $250 to $350 for each person enrolled-far below the average health care costs for treating one person with diabetes.
  • Controlling High Blood Pressure and Cholesterol: About one in three adults in the United States has high blood pressure, which increases the risk of heart disease and stroke, the first and third leading causes of death in the United States. About one in six adults has high cholesterol, which approximately doubles the risk of heart disease. In Asheville, NC, an employer-sponsored program to provide education and increase the use of and adherence to medications to control high blood pressure and cholesterol resulted in a more than an average 45 percent reduction per person in direct medical costs related to cardiovascular disease. And in the Minneapolis St. Paul region, a program to provide education and increase the use of and adherence to medications to control high blood pressure and cholesterol resulted in a more than 30 percent decrease ($3,678 reduction) in total annual health expenditures per person. This amounts to an annual savings of $12 for every $1 spent on providing these services.

Reduce Chronic Disease and Types of Awards

Community Transformation Grants will support two categories of activities: (1) building community capacity to implement changes and (2) implementing evidence-based and practice-based programs to achieve these changes.

  • Capacity-building awards will help local governments, nonprofit organizations, territories, and Tribal and American Indian/Alaska Native consortia build coalitions, train staff, conduct needs assessment, and develop action plans. This work will lay a solid foundation for community prevention efforts and help ensure their long-term success. These awards will total between $50,000 and $150,000.
  • Implementation awards will help communities operate the actual programs designed to help improve health and wellness. These awards will total between $500,000 and $10 million for States, local governments, and nonprofit organizations; between $50,000 and $150,000 for territories; and between $100,000 and $500,000 for Tribal and American Indian/Alaska Native consortia.

Supporting Administration Priorities on Prevention

The Community Transformation Grants are one piece of a broader effort by the Obama Administration to address the health and well-being of our communities through initiatives such as the President’s Childhood Obesity Task Force, the First Lady’s Let’s Move! campaign, the National Prevention Strategy, the National Quality Strategy, and HHS’ Communities Putting Prevention to Work program. The Prevention and Public Health Fund, as part of the Affordable Care Act, is supporting this and other initiatives designed to expand and sustain the necessary capacity to prevent disease, detect it early, manage conditions before they become severe, and provide States and communities the resources they need to promote healthy living. For more information about how the Fund is helping promote prevention in every State, visit

For More Information

For more information on this funding opportunity, visit and search for CFDA 93.531. Applications are due in July, and awards will be announced in late summer. For more information about the grants, including a list of frequently asked questions, visit

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