Public Health Frequently Asked Questions
Question: What health disparities exist between urban and rural areas?
Answer: According to Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 1, “there is ample evidence that some important rural-urban health disparities exist with respect to, for example, shortages of some types of primary care physicians (obstetricians and pediatricians), shortages of specialized mental health providers and oral health providers, prevalence of tobacco use and drinking-and-driving, and delays in screening and diagnosis of cancer. In addition, particular geographic, demographic, and cultural conditions in rural areas present obstacles to both rural residents seeking services and providers who would deliver them.”
The National Rural Health Association's Rural Minority Health Committee calls for a comprehensive strategic effort to address health disparities by improving:
- information and data;
- health policy and practices;
- health delivery systems; and
- health professions.
Many community health partnerships have formed in rural areas to help strengthen the health and health care delivery systems and social structures needed for effective prevention of disease and death.
Question: What are underlying issues that impact the public's health in rural communities?
Answer:
Many social and economic challenges unique to rural areas impact health status. Some examples include lower wages, disproportionately high housing costs (relative to wages), psychological impacts associated with increased isolation, fewer jobs, high numbers of under- or uninsured, increased risk of poverty, and lack of educational opportunities. The average age of people in rural communities is rising as a result of youth migration, which leaves behind an older population with limited support systems. Taken together, these factors contribute to increased inequities in the health status of rural people.
Question: What federal agency focuses on public health in rural areas?
Answer: The Office of Rural Health Policy (ORHP) promotes better health care service in rural America. Established in August 1987 by the Administration, the Office was subsequently authorized by Congress in December 1987 and located in the Health Resources and Services Administration. Congress charged the Office with informing and advising the Department of Health and Human Services 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, which is the Rural Assistance Center.
The Centers for Disease Control and Prevention (CDC) have some specific information about rural health outcomes linked to particular disease conditions and risk factors.
Question: Is there any funding for public health programs in rural communities?
Answer:
There are several sources to find out more about rural health funding. The National Association of County and City Health Officials (NACCHO) produces an online Foundation Funding Guide to identify funding resources at the national and state level from private foundations. Each month, the guide focuses on one area of public health, such as chronic disease, reproductive health, or access to care. Archived issues of the Foundation Funding Guide are also available online. NACCHO also provides some sources for research funding availability through its Rural Health program page.
The Rural Assistance Center (RAC) maintains a list of federal and foundation funding opportunities for public health. You can also search the entire RAC Funding Database, or contact RAC at 1-800-270-1898 or info@raconline.org to request a list of funding opportunities specific to your project and location.
Please see the Grantwriting information guide for more sources of funding opportunities.
Question: What is the public health infrastructure in rural areas?
Answer:
This is a difficult question to answer because the local public health infrastructure varies from state to state and community to community.
In 2005, the National Association of County and City Health Officials (NACCHO) conducted a survey of local public health agencies to find out about their infrastructure, which is reported in the 2005 Profile of Local Public Health Agencies.
Many rural areas do not have a local public health agency (LPHA) to provide essential public health services. Little is known about public health infrastructure in these communities. Services are often patched together by different agencies and service providers and vary depending on the state and community. Rural hospitals, private practice physicians, and community groups often play a role in providing the needed services for areas without an LPHA. For more information about rural public health infrastructure issues, please see the National Rural Health Association's policy brief Rural Public Health.
Other options to learn about the local public health infrastructure in a given state include searching the state's Department of Public Health website or contacting the local public health agency that serves a specific community.
Question: What public health services are provided in rural areas?
Answer:
Local public health agencies in rural areas of the United States provide a variety of services to their communities. These services may include direct clinical services, immunizations, chronic disease prevention, emergency response planning and environmental health. Each locality is different. The National Association of County and City Health Officials (NACCHO) is engaged in a project to define a functional local governmental public health agency. To learn more about this project, including the services included in, and the uses of the definition, please see NACCHO's Operational Definition of a Functional Local Public Health Agency.
Rural communities that do not have a local public health agency are likely to have fewer public health services available. Communities each adapt in their own way, with other agencies, local hospitals and providers stepping forward to address some or all of the public health needs.
Question: How can I locate my local governmental public health agency?
Answer:
Check your local phonebook for a listing of your local governmental public health agency or contact your town or city government offices. The agency may serve the city and/or the county and be listed as a health department, board of health, health district, or public health.
If your community does not have a local public health agency, contact your state Department of Public Health to learn about other agencies that may be providing public health services in your community.
Question: I am interested in pursuing a higher degree related to rural public health. Where should I start, and how can I find out about training and educational opportunities?
Answer: For information on rural public health education possibilities, please see the Association of Schools of Public Health and the Council on Education for Public Health, which are the two accrediting bodies for schools of public health. From there you can contact accredited schools to learn more about their programs and focus areas.
Schools which have a rural focus include:
Texas A&M University System Health Science Center's School of Rural Public Health; East Carolina University, Interdisciplinary Rural Health Training; and East Tennessee State University.
For more information on training, the Public Health Foundation coordinates TRAIN, an online learning resource to find and register for public health training.
Question: What issues are facing public health workers in rural communities?
Answer: NACCHO's Rural Health Project has conducted several focus groups and meetings to identify the major issues faced by rural public health professionals. There are six main issues that challenge rural public health agencies and service providers. They are:
- workforce development
- emergency preparedness
- effective public health advocacy
- public health infrastructure
- serving diverse populations
- finding funding for rural public health
Currently, NACCHO's primary focus is addressing rural public health workforce development, but it also provides resources to address some of the other concerns on this list.
The National Rural Health Association (NRHA) is a strong advocate for rural health issues. The Federal Emergency Management Association (FEMA) and the National Indian Health Board (NIHB) provide resources on tribal public health, a typically rural population with unique health concerns and needs.
Question: What criteria are used to define an area as rural?
Answer:
There are several different ways to define "rural" and different funding programs use different definitions. Please see the What is Rural? guide for detailed information on rural definitions and how to find out if your community would be considered rural.
Question: What other topics are related to public health?
Answer: Some topics related to public health include:
Question: Where can I find information particular to my region or state?
Answer: There are several good sources for finding information on a particular region or state. The Office of Rural Health Policy (ORHP) promotes state and local empowerment to meet rural health needs. ORHP's Directory of State Offices of Rural Health and State Rural Health Associations lists rural health contacts for each state. The ORHP-funded Rural Health Research Centers collect and analyze information on rural health access to quality care, workforce development and policy.
The National Rural Health Association (NRHA) has links to the State Rural Health Associations, as well as information on state budgets. The Association of State and Territorial Health Officials lists state and territorial health departments.
The Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) offers data from a national telephone survey, which can be used to identify emerging health problems and track health trends in a particular state. CDC’s National Center for Health Statistics also provides state and territorial-specific data.
Question: How can I connect to peers interested in rural public health issues?
Answer: To connect to peers interested in rural public health issues, you could join the National Rural Health Association (NRHA) Rural Public Health Interest Group. Membership in NRHA is required. If you are interested in joining the interest group, you can contact Michael Meit, Deputy Director, Walsh Center for Rural Health Analysis.
Credits
Last revised 11/02/2007
