Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop.
"[A] welcome addition to the rural health care practitioner's tool kit. It will energize those interested in vulnerable rural residents and their unique characteristics through a public health perspective... Highly recommended."--CHOICE: Current Reviews for Academic Libraries "This call to action for healthcare providers is a comprehensive review of issues in rural healthcare, including both obstacles and ways to begin to overcome them. It is easy to read... This enjoyable book encourages healthcare providers working or considering working in rural healthcare with clear direction."--Doody's Medical Reviews "The Warren & Smalley book is an excellent look at the challenges while also presenting solutions and hope. It recognizes the medical challenges that are present and the cost of bring medical care to these communities... There is so much in this book that will be refreshing and encouraging. The book needs to be read. It is also a book that needs to be placed in the hands of the movers and shakers, as well other interested parties who are in a position to 'make this happen.'" -- Illness, Crisis & Loss Rural residents face distinct health challenges due to economic conditions, cultural/behavioral factors, and health provider shortages that combine to impose striking disparities in health outcomes among rural populations. This comprehensive text about the issues of rural public health is the only book to focus on rural health from the perspectives of public health and prevention. It covers specific diseases and disorders faced by rural populations, service delivery challenges, practitioner shortfalls in rural areas, and promising community health approaches and preventive measures. The text also addresses rural health care ethics and international perspectives. Nearly all chapters offer best practice recommendations and evidence-based prevention programs. This book is a cohesive, centralized resource for researchers, public health practitioners, health organizations, and graduate education programs that focus on the public health of rural populations. Key Features: Comprises the only text to address rural health from the perspectives of public health and prevention Includes best practice recommendations and evidence-based prevention programs in each chapter Presents a cohesive, expansive synthesis of current research and practice Addresses specific diseases and disorders of rural populations, service delivery problems, and practitioner shortfalls in rural areas Discusses promising community health approaches and preventative measures
Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.
Klugman and Dalinis initiate a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. This volume initiates a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. Although 21 percent of the population lives in rural areas, only 11 percent of physicians practice there. What challenges do health care workers face in remote locations? What are the differences between rural and urban health care practices? What particular ethical issues arise in treating residents of small communities? Craig M. Klugman and Pamela M. Dalinis gather philosophers, lawyers, physicians, nurses, and researchers to discuss these and other questions, offering a multidisciplinary overview of rural health care in the United States. Rural practitioners often practice within small, tight-knit communities, socializing with their patients outside the examination room. The residents are more likely to have limited finances and to lack health insurance. Physicians may have insufficient resources to treat their patients, who often have to travel great distances to see a doctor. The first part of the book analyzes the differences between rural and urban cultures and discusses the difficulties in treating patients in rural settings. The second part features the personal narratives of rural health care providers, who share their experiences and insights. The last part introduces unique ethical challenges facing rural health care providers and proposes innovative solutions to those problems. This volume is a useful resource for bioethicists, members of rural bioethics committees and networks, policy makers, teachers of health care providers, and rural practitioners themselves.
Many of the 61 million people who live in rural America have limited access to health care. Almost a quarter of the nation's population lives in rural places yet only an eighth of our doctors work there. Sponsored by the U.S. Office of Rural Health Policy, this unique book provides the facts about this imbalance and interprets them in the context of government programs that promote the placement of doctors and the operation of hospitals in rural places while paying them less to treat Medicare and Medicaid beneficiaries. The authors' comprehensive analysis of rural health care delivery shows where there are differences in rates of death and disease between rural areas using maps, graphs, and plain-English descriptions. The book provides a thorough look at health care in rural America, giving a snapshot of how doctors, hospitals, and technology are unevenly distributed outside the nation's metropolitan areas.
Children in rural areas experience health disparities above and beyond their urban and suburban counterparts. In order to explore the needs of children and their families in rural health care settings, two research articles were completed: (a) a systematic literature review used to explore brief interventions for use in pediatric primary care and (b) a descriptive cross-sectional study done to analyze the influence of parental biopsychosocial characteristics on child health care utilization. The systematic review revealed a considerable need for empirically supported biopsychosocial brief interventions designed for use with under-served, rural children and their families. The research study revealed a relationship between parent biopsychosocial characteristics (e.g., mental health quality of life) and child health care utilization (both acute and non-acute) in a rural southeastern community health clinic; relationships were also identified between child medical chart diagnoses (e.g., asthma, depression, obesity) and parental scores on biopsychosocial measures. Recommendations developed from both articles are extended for clinicians, researchers, and policy makers who care about the needs of the rural and under-served children and families. Specific recommendations are also made for those who employ a relational lens to their research and who practice from a Medical Family Therapy orientation.
