Rural Public 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 assuring access to healthcare 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 even have the capacity to take advantage of opportunities for federal or state funding, gaps in public health capacities between rural and non-rural health departments are likely to increase.

Frequently Asked Questions


What federal agency focuses on public health in rural areas?

The Federal Office of Rural Health Policy (FORHP), located within the Health Resources and Services Administration, is the federal office that is charged with promoting better health and healthcare access for rural residents. It coordinates activities and policy work related to rural health within the Department of Health and Human Services. FORHP funds community-based health services grants, State Offices of Rural Health, and Rural Health Research Centers that research a variety of topics including public health.

While the Centers for Disease Control and Prevention (CDC) do not have a similar office directed to address rural issues, some CDC programs have targeted resources addressing rural health outcomes linked to particular disease conditions and risk factors.


Is there any funding for public health programs in rural communities?

RAC maintains a list of federal, state, and foundation funding opportunities for public health. You can also contact us at 1.800.270.1898 or info@raconline.org to request a list of funding opportunities specific to your project and location.


What is the public health infrastructure in rural areas?

This is a difficult question to answer because the local public health infrastructure varies from state to state and community to community.

The National Association of County and City Health Officials (NACCHO) conducts a survey of local public health agencies to find out about their infrastructure. The most recent findings from this are available in the 2013 National Profile of Local Health Departments. While useful, this resource only provides information for jurisdictions served by local health departments (LHDs). Less is known about areas without LHDs and how essential public health services are provided in these jurisdictions.

State public health agencies may provide some services to these communities, and other services may be provided by a patchwork of agencies and service providers. 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 health department website or contacting the local public health department that serves a specific community.

The National Indian Health Board provides information on tribal public health, a rural population with additional unique health concerns and needs.


What public health services are provided in rural areas?

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.

Some services may also be provided on a regional basis, either by the state health department, multiple local governments, or by independent local health departments sharing resources between jurisdictions. Strategies to regionalize services have been explored by many jurisdictions.

For additional information on topics related to public health, see these RAC topic guides:


How can I locate my local governmental public health agency?

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 agency. If your community does not have a local public health agency, contact your state health department to learn about other agencies that may be providing public health services in your community.


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?

For information on rural public health education possibilities, please see the Association of Schools & Programs 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.


What issues are facing public health workers in rural communities?

There are many issues facing public health workers including financial constraints, limited infrastructure, and access to workforce development opportunities. Yet, rural public health workers may also have opportunities to implement innovative public health solutions by leveraging their extensive relationships with community partners and lead the way in enhancing the health of the communities they serve.


Where can I find public health information particular to my region or state?

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.

RAC's State Guides and State-by-State Resources for Rural Health are good starting points for reports and data on a wide range of topics of interest to public health professionals. RAC's topic guide Finding Statistics and Data Related to Rural Health and Data Sources & Tools Relevant to Rural Health provide additional resources that include county-level and rural-specific data on public health topics.

Additional information may be available from these state-level organizations:


How can I connect to peers interested in rural public health issues?

To connect to peers interested in rural public health issues, you could join the National Rural Health Association (NRHA) Public Health Constituency Group, which represents members interested in community-level policy development and advocacy in order to promote access to healthcare services and tangible improvements in the community's overall health status. Membership in NRHA is required. If you are interested in joining the interest group, contact Michael Meit, Co-Director, NORC Walsh Center for Rural Health Analysis, at meit-michael@norc.org.