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 underinsured 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 residents.
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 annual online Foundation Funding Guide to identify funding resources at the national and state level from private foundations.
The Rural Assistance Center (RAC) maintains a list of federal, state, and foundation funding opportunities for public health. You can also 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 2008, 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 2008 Profile of Local Public Health Agencies.
Many rural areas do not have a local health department (LHD) 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 LHD.
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 health departments 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.
Rural communities that do not have a local health department 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.
Regionalization has been effective and is being considered in some parts of the country. Although accreditation is voluntary, a series of domains and standards are being developed to clarify expectations of local health departments. The goal of the accreditation program is to improve and protect the health of every community by advancing the quality and performance of public health departments.
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.
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: There are many issues facing public health workers including infrastructure, workforce development, emergency preparedness, etc and the National Rural Health Association (NRHA) is a strong advocate for rural communities facing these issues. The National Indian Health Board (NIHB) provides 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 Alana Knudson, Co-Director, Walsh Center for Rural Health Analysis.
Credits
Last revised 10/27/2009
