Outreach Programs to Reduce the Prevalence of Obesity in High Risk Rural Areas

The Centers for Disease Control and Prevention funds land-grant universities to implement evidence-based obesity prevention strategies in high-obesity rural counties through cooperative agreements and project grants under Assistance Listing 93.319, with the most recent grant award disbursed on September 30, 2018.

Program activity has stalled substantially. The portfolio contains 21 awards spanning 2014 to 2018, with the heaviest concentration in the initial year (13 awards in 2014) and minimal activity thereafter (1 award in 2015, 3 in 2016, 4 in 2018). No grant awards have been disbursed in the past eight years. The most recent grant opportunity, CDC-RFA-DP-23-0013 (The High Obesity Program), was posted August 3, 2022, with a due date of March 21, 2023—now closed. No currently open solicitations are evident from the source.

The program funds county-level implementation of evidence-based nutrition and physical activity interventions targeting populations in counties with adult obesity rates exceeding 40 percent. Recent awards demonstrate concrete scope: University of Wisconsin-Extension's project addressed diet-related chronic disease in Menominee County through policy, systems, and environmental changes to increase access to healthier foods and safe physical activity; Mississippi State University Extension implemented food system improvements and built-environment strategies across four counties; North Dakota projects promoted indigenous foodways to address health disparities tied to colonized diet patterns. Funding supports multi-sector collaboration across agriculture, transportation, education, business, and housing.

The assistance-type mix is predominantly Cooperative Agreements (15 of 21 awards, or 71 percent) with a smaller Project Grant component (6 awards, 29 percent). Award periods run 1 to 5 years with 12-month budget periods. All 21 awards were funded by the CDC; the portfolio shows no secondary funding agencies despite reporting three distinct funders.

Combined federal dollars obligated total $49.8 million across 21 awards. Recent awards ranged from $1.15 million to $7.96 million, with the 2018 cohort clustering in the $4–8 million range. The Alabama ALPROHEALTH cooperative agreement obligated $7.96 million; the Mississippi AIM for Change project obligated $7.88 million; Wisconsin's KEMAMACEQTAQ project obligated $4.30 million.

Eligibility is restricted to public higher-education institutions, specifically land-grant universities operating cooperative extension services. The 2023 NOFO sought applications from public institutions to serve counties meeting obesity-prevalence thresholds. Given the absence of awards since 2018 and no visible current solicitation, prospective applicants should verify whether CDC intends to reopen this line or has redirected resources to other obesity-intervention programs.