The State of Rural Public Health: Enduring Needs in a New Decade
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...
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| Veröffentlicht in: | American journal of public health (1971) 2020-09, Vol.110 (9), p.1283-1290 |
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| container_title | American journal of public health (1971) |
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| creator | Leider, Jonathon P Meit, Michael McCullough, J Mac Resnick, Beth Dekker, Debra Alfonso, Y Natalia Bishai, David |
| description | 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 this new decade. |
| doi_str_mv | 10.2105/AJPH.2020.305728 |
| format | Article |
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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. 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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 this new decade.</description><subject>AJPH Rural Health</subject><subject>Coronavirus Infections</subject><subject>Counties</subject><subject>COVID-19</subject><subject>Cultural differences</subject><subject>Cultural factors</subject><subject>Departments</subject><subject>Economic recovery</subject><subject>Expenditures</subject><subject>Great Recession</subject><subject>Health behavior</subject><subject>Health Services Accessibility</subject><subject>Health Status Disparities</subject><subject>High income</subject><subject>Humans</subject><subject>Inequality</subject><subject>Investment</subject><subject>Investments</subject><subject>Life expectancy</subject><subject>Life span</subject><subject>Low income groups</subject><subject>Mortality</subject><subject>Mortality, Premature - 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| source | MEDLINE; PAIS Index; Business Source Complete; Sociological Abstracts; EBSCOhost Education Source; PubMed Central; Alma/SFX Local Collection |
| subjects | AJPH Rural Health Coronavirus Infections Counties COVID-19 Cultural differences Cultural factors Departments Economic recovery Expenditures Great Recession Health behavior Health Services Accessibility Health Status Disparities High income Humans Inequality Investment Investments Life expectancy Life span Low income groups Mortality Mortality, Premature - trends Pandemics Peers Pneumonia, Viral Policy making Population Prescription drugs Public health Public Health Administration - economics Public Health Administration - statistics & numerical data Public Health Practice Rural areas Rural Health Rural Health - trends Rural Health Services - economics Rural Population - statistics & numerical data Rural urban differences Social services Trends United States Urban areas |
| title | The State of Rural Public Health: Enduring Needs in a New Decade |
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