The term "rural" suggests many things to many people, such as agricultural landscapes, isolation, small towns, and low population density.However, defining "rural" for health policy and research purposes requires researchers and policy analysts to specify which aspects of rurality are most relevant to the topic at hand and then select an appropriate definition. Rural and urban taxonomies often do not discuss important demographic, cultural, and economic differences across rural places-differences that have major implications for policy and research. Factors such as geographic scale and region also must be considered. Several useful rural taxonomies are discussed and compared in this article. Careful attention to the definition of "rural" is required for effectively targeting policy and research aimed at improving the health of rural Americans.

Residents of rural areas have increased travel distance and time compared to their urban counterparts. This is particularly true for rural residents with specific diagnoses or those undergoing specific procedures. Our results suggest that most rural residents do not rely on urban areas for much of their care.

Background: The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa.

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CHCs face substantial challenges in recruitment of clinical staff, particularly in rural areas. The largest numbers of unfilled positions were for family physicians at a time of declining interest in family medicine among graduating US medical students. The success of the current US national policy to expand CHCs may be challenged by these workforce issues.

The prevalence of obesity is higher in rural counties than in urban counties; obesity affects some residents of rural counties disproportionately.

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Context-Cancer care requires specialty surgical and medical resources that are less likely to be found in rural areas.Purpose-To examine the travel patterns and distances of rural and urban colorectal cancer (CRC) patients to 3 types of specialty cancer care services-surgery, medical oncology consultation, and radiation oncology consultation.Methods-Descriptive cross-sectional study using linked Surveillance, Epidemiology, and End Results (SEER) cancer registry and Medicare claims data for 27,143 individuals ages 66 and older diagnosed with stages I through III CRC between 1992 and 1996.Findings-Over 90% of rural CRC patients lived within 30 miles of a surgical hospital offering CRC surgery, but less than 50% of CRC patients living in small and isolated small rural areas had a medical or radiation oncologist within 30 miles. Rural CRC patients who traveled outside their geographic areas for their cancer care often went great distances. The median distance traveled by rural cancer patients who traveled to urban cancer care providers was 47.8 miles or more. A substantial proportion (between 19.4% and 26.0%) of all rural patients bypassed their closest medical and radiation oncology services by at least 30 miles.Conclusions-Rural CRC patients often travel long distances for their CRC care, with potential associated burdens of time, cost, and discomfort. Better understanding of whether this travel investment is paid off in improved quality of care would help rural cancer patients, most of whom are elderly, make informed decisions about how to use their resources during their cancer treatment.Cancer care requires sophisticated surgical and medical resources, including medical, surgical, and radiation therapy specialists. These specialists are less likely to be found in rural areas, especially small and isolated small rural areas, as their work can require tertiary hospital settings, found primarily in urban areas and rural areas with sizeable populations.1 -4 Several studies have found that rural cancer patients are less likely to receive state-of-the- This descriptive study examines the travel patterns and distances of elderly rural and urban CRC patients to 3 types of cancer care services-surgery, medical oncology consultation, and radiation oncology consultation, to determine whether rural elderly are disadvantaged by long distances to cancer care providers and to examine the degree to which rural elderly are bypassing local cancer care services. Having to travel long distances for care can be a burden for elderly cancer patients and has been associated with lower use of recommended services.9 -12 Bypassing local services, on the other hand, may represent poor access to cancer care if the closest providers' practices are full, patient or referring provider preference (eg, for a provider offering clinical trials), or lack of confidence in the quality of local services.13 This study's results can provide insights into interventions that might improve cancer service access for rural populations, such as trans...