The State of Rural Public Health: Enduring Needs in a New Decade

American Journal of Public Health
J P LeiderDavid Bishai

Abstract

Public health in the rural United States is a complex and underfunded enterprise. While urban-rural disparities have been a focus for researchers and policymakers alike for decades, inequalities continue to grow. Life expectancy at birth is now 1 to 2 years greater between wealthier urban and rural counties, and is as much as 5 years, on average, between wealthy and poor counties.This article explores the growth in these disparities over the past 40 years, with roots in structural, economic, and social spending differentials that have emerged or persisted over the same time period. Importantly, a focus on place-based disparities recognizes that the rural United States is not a monolith, with important geographic and cultural differences present regionally. We also focus on the challenges the rural governmental public health enterprise faces, the so-called "double disparity" of worse health outcomes and behaviors alongside modest investment in health departments compared with their nonrural peers.Finally, we offer 5 population-based "prescriptions" for supporting rural public health in the United States. These relate to greater investment and supporting rural advocacy to better address the needs of the rural United States in thi...Continue Reading

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Citations

Feb 10, 2021·New Solutions : a Journal of Environmental and Occupational Health Policy : NS·Sara A QuandtThomas A Arcury
Jan 20, 2021·The Public Policy and Aging Report·Danielle C RhubartClaire Pendergrast
Nov 22, 2020·International Journal of Environmental Research and Public Health·Adam HegeKellie Reed-Ashcraft
Feb 24, 2021·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Timothy CallaghanAlva O Ferdinand
Aug 27, 2021·AIDS and Behavior·Jo A ValentineMatthew Hogben

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