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 assuring access to health care services are 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. Investments over the past decade related to emergency preparedness planning, pandemic influenza, and implementation of the Affordable Care Act have highlighted deficits in infrastructure and capacities faced by many rural health departments. To the extent that areas without sufficient infrastructure may not have the capacity to utilize these resources, gaps in public health capacities between rural and non-rural health departments are likely to increase.
Related Guides
Frequently Asked Questions
Tools
2010 National Profile of Local Health Departments
Web site
Provides a comprehensive description of local health department (LHD) infrastructure and practices across the United States.
2012 County Health Rankings
Web site
Includes a collection of reports that rank the health of nearly every county in the nation on their overall health. Each county is ranked within the state on how healthy people are and how long they live. They also are ranked on key factors that affect health such as: smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates, fast-food restaurants, physical inactivity, and number of children living in poverty.
All Hazards: Resources to Help Rural Communities Prepare for Disasters and Other Hazards
Web site
Provides resources to help citizens of rural agricultural communities prepare for and recover from a number of natural and man-made threats.
America's Health Rankings
Web site
Provides twenty years of data and offers recommendations to address health risk behaviors and their negative outcomes. Includes state-by-state snapshots.
APHA: Community Health Workers Section
Web site
Promotes the community's voice within the health care system through development of the role of Community Health Workers (including Promotores de Salud, Community Health Representatives, Community Health Advisors and related titles) and provides a forum to share resources and strategies.
Behavioral Risk Factor Surveillance System (BRFSS)
Database
Provides access to reports, surveys, and fact sheets from the BRFSS, a telephone survey that tracks health risks in the United States. Data is available by state and for the nation.
Community Health Status Indicators (CHSI)
Web site
Designed to inform public health professionals and community members about state- and county-level health status indicators such as: causes of death, tobacco use, diet, physical activity, and drug and alcohol use. Available reports also include Healthy People 2010 targets, information on vulnerable populations, and access to care.
Community Health Workers Toolkit
Web site
Contains eight modules about community health worker programs, how the programs work and how to use community health workers in the local community.
County Health Roadmaps
Web site
Helps counties throughout the U.S. mobilize and take action to create healthier places to live, work, and play. Includes a checklist of various tools to help groups work together.
Flu.gov
Web site
Information on the flu, where to find a vaccine, and free resources for schools and communities. Includes national planning and response information and state pandemic plans.
Healthy People 2020
Web site
Presents the schedule for Healthy People 2020, a 10-year national objective for promoting health and preventing disease. Works to achieve increased quality and years of healthy life and the elimination of health disparities.
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: Funding Opportunities
Web site
Identifies public health-related funding resources at the national and state levels from private foundations, governmental sources, and non-governmental sources.
NACCHO: Model Practices Database
Database
Lists effective and innovative public health practices, searchable by state and topic.
NACCHO: Toolbox
Web site
Collection of local public health tools produced by members of the public health community. Examples include presentations, fact sheets, drills, evaluations, protocols, templates, reports, and training materials.
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.
Public Health Resources: State Health Departments
Web site
A directory of state health departments.
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.
Resource Guide for Public Health Preparedness
Web site
Gateway to freely available online resources related to public health preparedness. Resources include expert guidelines, factsheets, websites, research reports, articles, and other tools aimed at the public health community.
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.
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.
Regulations, Forms & Other Useful Documents
At the Intersection of Public Health and Transportation: Promoting Healthy Transportation Policy
Sponsoring organization: American Public Health Association
Provides evidence-based information about how transportation policy and practice in suburban, urban and rural communities affect public health.
Date: 2010
Challenges, Opportunities, and Strategies for Rural Public Health Agencies Seeking Accreditation
Author(s): Michael Meit, Karen Harris, Jessica Bushar, Bhumika Piya, Maria Molfino
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Enhances understanding of how public health infrastructure may dictate rural health departments’ approaches to seeking accreditation.
Date: 06 / 2008
Environmental Workforce Characteristics in the Rural Public Health Sector (Final Report)
Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice
Sponsoring organization: West Virginia Rural Health Research Center
Analyzes the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services.
Date: 12 / 2011
Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
Author(s): Michael Meit, Benjamin N. Hamlin, Bhumika Piya, Lorraine Ettaro
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Discusses whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state and local level public health infrastructure.
Date: 06 / 2008
For the Public’s Health: The Role of Measurement in Action and Accountability
Sponsoring organization: Institute of Medicine
Reviews current approaches for measuring the health of individuals and communities and suggests changes in the processes, tools, and approaches used to gather information about health outcomes and their determinants.
Date: 2010
Health Reform and Local Health Departments: Opportunities for the Centers for Disease Control and Prevention
Sponsoring organization: Public Health Institute
Reports on local health departments (LHDs), including rural, the forces shaping their services and roles, their strategies for the future, their perspectives on the role of public health in a reforming health care system and finally how the CDC can support LHDs in the future.
Date: 05 / 2010
Health, United States, 2001 With Urban and Rural Health Chartbook
Sponsoring organization: National Center for Health Statistics
Includes a chartbook that highlights rural-urban differences and presents information on population characteristics, health-related behaviors, health status, and health care access and use for five levels of urbanization and four regions of the United States.
Date: 2001
Health, United States, 2011: With Special Feature on Socioeconomic Status and Health.
Sponsoring organization: Centers for Disease Control and Prevention
Uses tables and narrative to present trends and information regarding the Nation's health status, demographic distribution, health insurance coverage and expenditures, health behaviors and risk factors, and the utilization and access to health care.
Date: 05 / 2012
Implications of Health Reform for Community-Based Organizations
Sponsoring organization: Georgia Health Policy Center
This third brief in a series on the Patient Protection and Affordable Care Act, addresses provisions that apply to community health initiatives.
Date: 05 / 2010
Local Health Department Job Losses and Program Cuts: Findings from January/February 2010 Survey
Sponsoring organization: National Association of County and City Health Officials
Illustrates the challenges that local health departments face as they struggle to provide basic disease prevention and emergency preparedness services in the face of budget cuts.
Date: 05 / 2010
Place-based Policies and Public Health: The Road to Healthy Rural People and Places
Author(s): Keith J. Mueller, A. Clinton MacKinney, Mario Gutierrez, Jocelyn Richgels
Sponsoring organization: Rural Policy Research Institute
Identifies how the Patient Protection and Affordable Care Act of 2010 (ACA) can influence the determinants of health and contribute to the prosperity, equity, sustainability, and livability of rural places.
Date: 03 / 2011
Preparedness and Response to a Rural Mass Casualty Incident: Workshop Summary
Author(s): Kristin Viswanathan, Theresa Wizemann, Bruce Altevogt
Sponsoring organization: Institute of Medicine
Discusses problems in contacting emergency services when incidents occur in rural areas such as, delayed assistance, limited or no cell phone service, limited access to land lines, no 911 service, transportation, lack of hospital resources, and distances between hospitals and incident sites.
Date: 2011
Public Health, Workforce, Quality, and Related Provisions in the Patient Protection and Affordable Care Act (PPACA)
Author(s): Erin D. Williams, C. Stephen Redhead
Sponsoring organization: Congressional Research Service
One in a series of CRS products on PPACA (as amended by HCERA), summarizes the new law’s workforce, public health, quality, and related provisions. Covers provision implications on rural and underserved areas.
Date: 06 / 2010
Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism
Author(s): Jeffrey Levi, Serena Vinter, Laura M. Segal
Sponsoring organization: Trust for America's Health
Informs the public and policymakers about
the status of public health preparedness in
the United States. Provides state-by-state public health preparedness indicators and scores. Addresses rural public health issues.
Date: 12 / 2009
Rural Environmental Justice: Healthy Environments, Shared Decision-Making, and Sustainable Communities
Sponsoring organization: National Rural Assembly
Describes the results of phone interviews with representatives from government agencies, nonprofit organizations, academic institutions,
and rural communities throughout the country on the topic of environmental justice in rural communities. Identifies related policy goals and opportunities.
Date: 2011
Rural Health Issues: Implication for Rural Healthy People 2020
Sponsoring organization: National Rural Health Association
Outlines NRHA's main rural health concerns for the next decade as they prepare to draft the Rural Healthy People 2020 companion document to Healthy People 2020.
Rural Healthy People 2020
Author(s): Jane N. Bolin, Gail Bellamy
Sponsoring organization: Texas A&M School of Rural Public Health
Outlines the strategic plan for completing Rural Healthy People (RHP) 2020, names the top priority areas to be addressed, and describes the next steps toward its development. RHP 2020 will aim to identify rural health priorities, support rural health leaders and researchers, and promote effective rural health programs.
Rural Public Health Agency Accreditation (Final Report)
Author(s): Michael Meit, Karen Harris, Jessica Bushar, Bhumika Piya, Maria Molfino
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Studies the barriers and opportunities to public health agency accreditation among state and local health departments serving rural jurisdictions.
Date: 06 / 2008
Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding
Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Describes how federal funds for disease prevention and health promotion activities are distributed to
local health departments (LHDs) and non-governmental organizations (NGOs) at the rural local level.
Date: 06 / 2008
Shortchanging America's Health: A State-By-State Look at How Federal Public Health Dollars Are Spent, 2010
Author(s): Jeffrey Levi, Rebecca St. Laurent, Laura M. Segal, Serena Vinter
Sponsoring organization: Trust for America's Health
Reviews key health statistics and a range of federal public health funds that each state receives.
Date: 03 / 2010
Toxics Release Inventory Discharges and Population Health Outcomes in Rural and Urban Areas of the United States (Final Report)
Author(s): Michael Hendryx, Evan Fedorko, Juhua Luo
Sponsoring organization: West Virginia Rural Health Research Center
Examines whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program were associated with population mortality rates and birth outcomes for both rural and urban populations.
Urban to Rural Evacuation: Planning for Rural Population Surge (Final Report)
Author(s): Michael Meit, Alene Kennedy, Thomas Briggs
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Analyzes the likelihood of urban evacuation to rural areas and provides recommendations for rural planning and response.
Date: 08 / 2008
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.
Open Public Health Journal
Online journal which publishes original research articles, reviews and short articles in the field of public health.
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 that compiles statistical information to guide actions and policies to improve health.
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.
Office of Rural Health Policy (ORHP)
Federal government
Coordinates activities related to rural health care within the U.S. Department of Health and Human Services. Part of the Health Resources and Services Administration (HRSA). 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.
Trust for America's Health (TFAH)
Nonprofit/Foundation
Works to protect the health of every community and to make disease prevention a national priority.
Article Searches & Bibliographies
RAC Documents Search: Public Health
PubMed Search: Public Health and Rural Health Services
Searches PubMed's collection of journal article citations with abstracts for items related to this topic and published in the United States during the last four years.
Some citations link to the full text of articles through PubMed Central, through your library’s electronic and print holdings, or through the journal's publisher. The first two provide free access; the latter may require payment. Check with your local library for details or call your Regional Medical Library at 800.338.7657.
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