The State of Rural Public Health

Enduring Needs in a New Decade

Bibliographic Data

ID11024983
AuthorsJonathon P Leider (0000-0001-9905-476X, Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.), Michael Meit (Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.), J Mac McCullough (0000-0002-0070-4943, Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.), Beth Resnick (0000-0001-6214-9378, Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.), Debra Dekker (0000-0001-7072-5785, Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.), Y Natalia Alfonso (0000-0002-7148-4407, Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.), David Bishai (0000-0003-0714-9062, Jonathon P. Leider is with the School of Public Health, University of Minnesota, Minneapolis. Michael Meit is with NORC at the University of Chicago, Bethesda, MD. J. Mac McCullough is with Arizona State University College of Health Solutions, Phoenix. Beth Resnick, Y. Natalia Alfonso, and David Bishai are with Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Debra Dekker is with National Association of County and City Health Officials (NACCHO), Washington, DC.)
Year2020
Volume110
Issue9
Pages1283-1290
Publication date2020-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2020.305728
PMID32673103
OpenAlexW3042388343
LanguageEN
Citations received47
References cited16

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

Demographic economics · Economic growth · Economics · Environmental health · Geography · Health care · Health equity · Inequality · Investment (military) · Life expectancy · Political science · Population · Population health · Public health · Rural area · Food Security and Health in Diverse Populations · Global Health Workforce Issues · Medicine · Public Health Policies and Education

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