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Introduction
Public health has been called a system of "organized community efforts aimed at the prevention of disease and promotion of health." The public health needs of rural Americans are unique and challenging. Disparities in chronic disease prevalence and related health behaviors, issues of diversity and shifting population demographics, and access and coverage for the underinsured & uninsured all become more complicated in rural areas. Rural health departments, in addressing these issues, face challenges regarding workforce recruitment, retention and training, epidemiologic investigation, information technology, and telecommunications.
The recent enhanced focus on emergency preparedness planning has only highlighted the overall struggles faced by rural health departments in gaining support to enhance the rural public health infrastructure. The resources on this page provide specific information on rural health, as well as funding sources and tools that can be used to improve health care for America's rural population.
Frequently Asked Questions
Tools
2005 Profile of Local Health Departments
Web site
Results of a survey of local health departments (LHDs) across the nation. Includes information on a wide range of LHD-related topics, including
jurisdiction; governance; financing; characteristics of top executives; workforce;
activities and services; planning and performance improvement; partnerships;
policy-making activities; and information technology.
ASTHO's State and Territorial Links
Web site
Links to U.S. state and territorial health departments.
Be Med Wise
Web site
A public education initiative by the National Council on Patient Information and Education (NCPIE) - a nonprofit coalition of over 125 consumer, government, patient advocacy and public health organizations. NCPIE serves as a trusted source of reliable information about the proper use of medicines, and Be MedWise seeks to promote a better understanding that over-the-counter (OTC) drug products are serious medicines and must be taken with care.
Behavioral Risk Factor Surveillance System (BRFSS)
Database
Access to data and other information from the BRFSS, a telephone survey that tracks health risks in the United States. Data is available by state and for the nation.
Biochemical Organic Radiological Disaster Educational Response System (BORDERS)
Web site
BORDERS, a continuing education and training program, is designed to improve the individual and collective ability of healthcare professional practitioners to prepare for and respond to acts of bioterrorism in increasingly diverse situations and populations.
Business Pandemic Influenza Planning Checklist
Web site
Checklist large businesses can use to prepare in the event of an influenza pandemic.
CDC Influenza (Flu): Protect Yourself and Your Loved Ones
Web site
Provides key facts, prevention information, and frequently asked questions regarding the flu.
Communicate to Make a Difference: Exploring Cross-Cultural Communication
Tutorial
Free, interactive online course on culture and communication in public health. Designed for public health professionals. The course can be completed at your own pace within a 30-day period.
Community Health Colleague Connection
Web site
Free, web-based referral service to connect public health practitioners with colleagues who are willing to share their experiences and answer questions.
Factline: Tracking Health in Underserved Communities
Web site
Information and resources on health disparities in underserved communities. Includes sections on women's health, mental health, minority health, and health care access.
Foundation Funding Guide: Chronic Disease
Web site
Lists state and national foundations with an interest in chronic disease.
Foundation Funding Guide: Environmental Health
Web site
Lists state and national foundations with an interest in environmental health.
Foundation Funding Guide: General Public Health
Web site
Lists state and national foundations with an interest in public health.
Foundation Funding Guide: Immunization
Web site
Lists state and national foundations with an interest in immunization.
Foundation Funding Guide: Injury Prevention
Web site
Lists state and national foundations with an interest in injury prevention.
Foundation Funding Guide: School Health
Web site
Lists state and national foundations with an interest in school health.
Health Disparities Projects and Interventions Database
Database
Public health projects and interventions submitted by the public health community. Search by topic, keyword, race/ethnicity, age group, and state. See the category "Reducing geographic challenges" for rural-specific projects. Includes detailed project descriptions and project contacts.
Healthy People 2010 Toolkit
Web site
Provides guidance, technical tools, and resources to help states, territories, and tribes develop and promote successful state-specific Healthy People 2010 plans.
Indoor Air Quality (IAQ) Tools for Schools
Web site
A comprehensive resource to help schools maintain a healthy environment in school buildings by identifying, correcting, and preventing indoor air quality problems.
Mobilizing for Action through Planning and Partnerships (MAPP)
Web site
Community-wide strategic planning tool for improving community health. Helps communities prioritize public health issues and identify resources for addressing them. Registration required.
NACCHO's Foundation Funding Guide
Web site
Each month, the guide lists national and state funding sources on a specific public health topic. Past topics include Access to Health Care and Reproductive Health.
NACCHO's Model Practices Database
Database
Lists effective and innovative public health practices, searchable by state and topic.
NACCHO's Rural Health Project
Web site
Information about NACCHO's rural public health activities, as well as rural public health news, events, funding and links to resources.
Operational Definition of a Local Health Department
Web site
NACCHO has developed an operational definition of a local health department (LHD). The overarching goal of this project defines a shared understanding of what people in any community, regardless of size, can expect from their LHD.
Pandemic Flu
Web site
Information on pandemic flu and avian influenza. Includes national planning and response information and state pandemic plans.
Partners in Information Access for the Public Health Workforce
Web site
Information and resources to help the public health workforce find and use information effectively. Includes funding sources, data and statistics, career resources and more. Provided by a collaboration of U.S. government agencies, public health organizations and health sciences libraries.
Promising Practices: Pandemic Preparedness Tools
Web site
Aims to enhance public health preparedness for an influenza pandemic and conserve resources by sharing promising practices. Includes examples of models for care during a pandemic, communication tools, and mitigation tools.
Public Health Infrastructure Resource Center
Web site
Information and resources to support the public health infrastructure. Covers public health workforce, communications, bioterrorism and more.
Radiation Exposure Screening & Education Program (RESEP)
Web site
Awards grants to health care providers in the 12 states most affected by the Cold War's nuclear weapons industry. Helps thousands of individuals diagnosed with cancer and other diseases caused by exposure to nuclear fallout or nuclear materials such as uranium.
Rural Health Research: Public health
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of public health, produced by the Office of Rural Health Policy's funded rural health research centers.
State of Public Health Preparedness Issue Module
Web site
Summarizes and provides links to the latest data and research on major issues in public health preparedness, such as infrastructure and workforce, funding, emergency response and prevention, delivery system capacity, and the role of government.
TrainingFinder Real-time Affiliate Integrated Network (TRAIN)
Database
Information on learning opportunities, particularly online learning, for health care professionals who work for the public's health. Searchable by subject, keyword, target audience, core competencies, etc.
Your State's Health
Web site
State-based health information, including adult and child health indicators, health disparities, bioterrorism preparedness, and federal funding to the state for health.
Regulations, Forms & Other Useful Documents
2005 National Profile of Local Health Departments
Sponsoring organization: National Association of County and City Health Officials
Results of a study which developed a comprehensive and accurate description of local health department (LHD) infrastructure and practice. Includes information on a wide range of LHD-related topics, including jurisdiction; governance; financing; characteristics of top executives; workforce; activities and services; planning and performance improvement; partnerships; policy-making activities; and information technology.
Date: 07 / 2006
Building Healthier Communities: Local Nutrition and Physical Activity Programs
Sponsoring organization: National Association of County and City Health Officials
Provides examples of local public health agency programs that address individual nutrition and physical activity as well as environmental and policy changes.
Chronic Disease Management Systems (Registries) in Rural Health Care
Author(s): Anne Skinner, Roslyn Fraser-Maginn, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Discusses the types of Chronic Disease Management Systems (CDMSs) used by a sample of 14 state organizations and 19 local rural clinics in Maine, Nebraska, New Mexico, South Carolina, Washington, and Wisconsin.
Date: 05 / 2006
Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States
Author(s): Christopher J. L. Murray, Sandeep C. Kulkarni, Catherine Michaud, Niels Tomijima, Maria T. Bulzacchelli, Terrell J. Iandiorio, Majid Ezzati
Describes a study that used race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate to divide the U.S. population into eight distinct groups, in order to explore the causes of the health disparities among these groups. Includes life expectancy comparisons among groups, with several groups specifically identified as rural.
Journal citation: PLoS Medicine Volume 3 Issue 9
Date: 09 / 2006
Health, United States, 2007 with Chartbook on Trends in the Health of Americans
Sponsoring organization: National Center for Health Statistics
Presents national trends in health statistics. Each report includes an executive summary, highlights, a chartbook, trend tables, extensive appendixes,
and an index. Includes data on this year's special feature on access to health care.
Date: 2007
Innovations in Public Health: Understanding State Public Health
Sponsoring organization: Association of State and Territorial Health Officials
Creates a common understanding of the scope and responsibilities of state public health.
Date: 04 / 2007
Organizing State and Local Health Departments for Public Health Preparedness
Author(s): Jeffrey Wasserman, Peter Jacobson, Nicole Lurie, Christopher Nelson, Karen Ricci, Molly Shea, James Zazzali, Martha I. Nelson
Sponsoring organization: RAND Corporation
Examines whether state and local public health agencies relate to one another in a way that facilitates emergency response and preparedness.
Date: 2006
Overcoming Obstacles to Health
Sponsoring organization: Robert Wood Johnson Foundation
Describes the current health profile of Americans, looking specifically at how education, income, race and ethnicity play a role in Americans' health.
Date: 02 / 2008
Preparing for Public Health Emergencies: Meeting the Challenges in Rural America
Sponsoring organization: University of Pittsburgh Center for Rural Health Practice
Identifies barriers facing rural public health preparedness and the strategies to
overcome those barriers. Conference proceedings from a national rural preparedness meeting of 81 public health preparedness leaders held in Saint Paul, MN, September 27-28, 2004.
Date: 09 / 2004
Public Health and Information Technology at the United States-Mexico Border: Examples Show Potential
Sponsoring organization: Office of Rural Health Policy
Examines the use of health information technology (HIT) in public health programs at the United States-Mexico border, with an emphasis on frontier and rural health. Includes examples of successful projects addressing tuberculosis, immunizations, and diabetes.
Date: 02 / 2007
Public Health Preparedness: Integrating Public Health and Hospital Preparedness Programs
Author(s): Lois M. Davis, Jeanne S. Ringel, Sarah K. Cotton, Belle Griffin, Elizabeth Malcolm, Louis T. Mariano, Jennifer E. Pace, Karen Ricci, Molly Shea, Jeffrey Wasserman, James Zazzali
Sponsoring organization: RAND Corporation
Examines different models for coordination that local health departments and general acute-care hospitals have employed to improve public health preparedness.
Date: 2006
Public Health Worker Shortages: Trends Alert
Author(s): Melissa Taylor Bell
Sponsoring organization: Council of State Governments
Discusses results of a survey done with human resource directors in state public health offices regarding public health workforce issues.
Date: 11 / 2004
Rural Healthy People 2010: Rural Public Health Infrastructure
Author(s): Barbara Quiram, Michael Meit, Kay Carpender, Cara Pennel, Graciella Castillo, Delia Duchicela
Sponsoring organization: Southwest Rural Health Research Center
Addresses rural health issues associated
with the Healthy People 2010 focus area on public health infrastructure.
Date: 01 / 2005
Rural Healthy People 2010: Rural Public Health Infrastructure: A Literature Review
Author(s): Barbara Quiram, Michael Meit, Kay Carpender, Cara Pennel, Graciella Castillo, Delia Duchicela
Sponsoring organization: Southwest Rural Health Research Center
Detailed literature review of rural health issues associated with the Healthy People 2010 focus area on public health infrastructure.
Date: 01 / 2005
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 1
Author(s): Larry D. Gamm, Linnae L. Hutchison, Betty J. Dabney, Alicia M. Dorsey, eds.
Sponsoring organization: Southwest Rural Health Research Center
Brief overviews of the top rural health concerns and objectives associated with Healthy People 2010 focus areas, references to key literature about these concerns, and descriptions of models for practice that rural communities can draw upon to achieve key Healthy People 2010 objectives.
Date: 2003
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 2
Author(s): Larry D. Gamm, Linnae L. Hutchison, Betty J. Dabney, Alicia M. Dorsey, eds.
Sponsoring organization: Southwest Rural Health Research Center
Detailed literature reviews and associated references for the top rural health concerns addressed in Vol. 1 of Rural Healthy People 2010.
Date: 2003
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 3
Author(s): Larry D. Gamm, Linnae L. Hutchison, eds.
Sponsoring organization: Southwest Rural Health Research Center
Addresses several rural health concerns and objectives not covered in Volumes 1 and 2 of Rural Healthy People 2010. Includes overviews, literature reviews, and accompanying models for practice for four rural health topics.
Date: 02 / 2005
Rural Public Health: Issues and Considerations
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
Report to the Secretary of the U.S.
Department of Health and Human Services. Overview of the rural public health infrastructure. Addresses public health leadership, workforce preparedness, support for safety net providers, the impact of managed care, telecommunications, and funding for rural public health.
Date: 02 / 2000
Urban-to-Rural Evacuation: Planning for Population Surge: Policy Analysis Brief
Author(s): Michael Meit, Alene Kennedy, Thomas Briggs
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Discusses disaster planning and how rural preparedness officials face significant informational, organizational, and infrastructural constraints in their abilities to prepare for a potential population surge from urban areas.
Date: 04 / 2007
Journals
American Journal of Public Health
Monthly journal covering public health research, research methods, and program evaluation. Available by subscription online or in print.
NACCHO Exchange
Quarterly publication addressing public health topics. Available for purchase.
Rural Roads
NRHA magazine focusing on human-interest stories and successful rural programs.
Organizations
American Public Health Association (APHA)
National organization
Works to influence policies and set priorities in public health.
Association of State and Territorial Health Officials (ASTHO)
National organization
National nonprofit organization representing the state and territorial public health agencies of the United States, the U.S. Territories, and the District of Columbia. ASTHO's members are dedicated to formulating and influencing sound public health policy, and to assuring excellence in state-based public health practice.
Kaiser Family Foundation (KFF)
Nonprofit/Foundation
An independent philanthropy focusing on the major health care issues facing the nation. Acts as a source of facts and analysis for policymakers, the media, the health care community, and the general public.
National Association of County and City Health Officials (NACCHO)
National organization
Provides education, information, research, and technical assistance to local health departments.
National Association of Local Boards of Health (NALBOH)
National organization
Works to strengthen local boards of health, enabling them to promote and protect the health of their communities, through education, technical assistance and advocacy.
National Center for Health Statistics (NCHS)
Federal government
The United States' principal health statistics agency. Compiles statistical information to guide actions and policies to improve health. Part of the Centers for Disease Control and Prevention (CDC), U.S. Department of Health & Human Services.
National Network of Public Health Institutes (NNPHI)
National organization
Works to recognize and enhance the work being done in public health by independent, nonprofit collaborative entities.
National Rural Health Association (NRHA)
National organization
Promotes leadership, ideas, information, communication, education, research, advocacy, and methods to improve rural health. Composed of individual and organizational members who share a common interest in rural health.
Office of Rural Health Policy (ORHP)
Federal government
Promotes better health care service in rural America. Part of the Health Resources and Services Administration, U.S. Department of Health and Human Services. Focuses on matters affecting rural hospitals and health care, coordinating activities within the department that relate to rural health care, and maintaining a national information clearinghouse.
Public Health Data Standards Consortium (PHDSC)
National organization
A non-profit membership-based organization of federal, state and local health agencies; national and local professional associations; academia, public and private sector organizations; international members, and individuals.
Public Health Foundation
Nonprofit/Foundation
Assists health agencies and other community health system organizations by providing objective information in areas such as health improvement planning, understanding and using data, and improving performance.
State Public Health.org
National organization
Promoting sound public health policy
and providing answers for questions about communicable diseases
Serving State Public Health interests by finding innovative solutions is this site's priority.
Trust for America's Health (TFAH)
Nonprofit/Foundation
Works to protect the health of every community and to make disease prevention a national priority.
University of Pittsburgh Center for Rural Health Practice
Academic/Research
Identifies and articulates health issues relevant to rural America. Works with all University of Pittsburgh campuses and schools, and with the UPMC Health System, providing access to many of the nation's top health researchers.
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