Care about Public Health in America? Than You Should Read This

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I recently came upon a report that caught my eye and it should catch yours too if you’re interested in improving the well-being of Americans. A quick review of Healthy People 2010: A Companion Document for Rural Areas produced evidence of the many diverse public health disparities that exist between rural and urban regions. Each of these disparities challenge American policy makers to consider how current and future health reform will affect rural Americans differently then their urban counterparts. [The following is adapted from the National Rural Health Association’s “What Different about Rural Health?”]

NINE WAYS THAT AMERICAN RURAL HEALTH DIFFERS

1. Income Disparities: The average rural income is $19,000 per year in comparison to $26,000 per year found in urban counterparts.

2. Motor Vehicle Incidents: While rural areas account for only one third of all motor vehicle incidents, approximately 66% of the deaths from motor vehicle incidents occur in rural areas.

3. Smoking: When rural 8^th graders were surveyed, some 26% reported that they smoked. This is twice the percentage of urban 8^th graders who reported similar smoking habits (only some 12%).

4. Childhood Poverty: Rural children are much more likely to be poor than urban children.

5. Mental Health: A great majority, some 87% in fact, of the Mental Health Professional Shortage areas are in America’s rural communities.

6. Teeth and Gums: While there are approximately 60 dentists per 100,000 people in urban settings, there are only 40 dentists for the same rural population.

7. Cardiovascular Health: Hypertension rates in rural areas (128.8 per 1,000 rural residents) is much higher than urban counterparts (101.3 per 1,000 urban residents).

8. Transportation: Greater distance and transportation obstacles exist for rural residents who are trying to make it between their place of residence and a physician or specialist’s office.

9. Workforce: While approximately twenty percent of Americans (63 million) live in rural areas, only ten percent of physicians practice in rural America.

What do these disparities have to do with healthcare and health policy? Everything. Keep checking back for more insight into how geography affects health in America and what we can do about it.

The Health of America’s Rural Residents Could Hinge on Today’s Mass. Senate Election

Posted by Allison S. Bybee |1 comments

On what is predicted to be an icy, wintery day across the state of Massachusetts, two very different candidates are vying for much more than a Senate seat – each are poised to be a tipping point for what might be characterized as a watershed moment in national and rural healthcare policy.

No matter which candidate captures the most votes in today’s election, at the very least Massachusetts’ political history is guaranteed to be made. If state Senator Scott Brown takes a majority of the vote, then he will be the first Massachusetts Republican senator in over 40 years. On the other hand if current Massachusetts’ Attorney General, Martha Coakley captures a majority of votes, she will be declared as the first female senator from the Bay State.

Yet outside of the scrolls of Massachusetts’ history, there are much greater national stakes are to be had. In the short term, a Republican win here could eliminate the Democratic Party’s current filibuster proof margin in the Senate and would put the ongoing national health care reform process in serious jeopardy. In the long term, a Republican win could very well energize a recently crippled Republican party. Ultimately, such a win in a state where Democrats outnumber Republicans 3 to 1, would place many Democratically-held congressional seats in jeopardy for the 2010 election cycle and could be heralded as a precursor to a crushing fall term for Democratic incumbents across the nation.

For America’s approximately 63 million rural residents, a Democratic defeat in today’s election could vanquish the nascent hope for health reform bills that promise to progressively impact rural health access and system-wide rural health policy. Currently, facets of both health reform versions aim target two critical overarching priorities in American rural health - reducing rural health workforce shortages while concurrently minimizing decades old disparities in medical reimbursement. If a “conferenced,” or compromised, version of health reform can not pass both houses of Congress in the coming weeks, then the health of rural residents will not doubt suffer. How much and exactly in what ways only time will tell.

[For more details on how current health reform could alter the fiber of American rural health policy, stay tuned for next week’s posting.]

Welcome to Notes from the Frontier!

Posted by Allison S. Bybee |0 comments

This blog will provide resources, opinions, and the opportunity to discuss issues relating to contemporary rural health policy in America.

Furthermore, it is hoped that this blog will be a forum for Yale students and faculty members to express their interests in improving Yale University’s utter dearth of a rural health curriculum.

Both opposing and supporting comments are welcomed and helpful!

Notes from the Frontier was created and is currently administered by Allison S. Bybee of Yale University’s School of Public Health.