The Double Disparity Facing Rural Local Health Departments

Abstract

Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities.

Epidemiology of Influenza Virus Reinfection: A Retrospective Analysis of a Nine-year Influenza Surveillance Data

“…In addition, our study suggests that people living in rural areas were more likely to get re-infected, which is consistent with previous studies that showed that rural residences presented a risk factor with respiratory disease [22]. The high risk of reinfection might be attributed to less access to health education and host behavior, such as higher rates of tobacco use, physical inactivity, lower rates of fruit and vegetable intake [23].…”

Social Determinants of Health and the Effects on Quality of Life and Well-being in 2 Rural Appalachia Communities

“…Because of this, rural citizens are also much more likely to utilize services offered by their local health department, which have a double disparity in dealing with poorer health among the populace and a lack of public investment to support their efforts. 49 In the region where the present study took place, the local health department is on the other side of the county, approximately 15 miles and more than 30 minutes of driving time. Further complicating the issue of distance is that access to transportation is a major barrier.…”

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research

“…Two national studies have shown that A-EBPs are far less likely to be used by local health departments with jurisdictions of less than 25,000 persons (from 3 to 4 times less likely to apply A-EBPs than health departments with jurisdictions of 500,000 persons or more) (29, 59). This highlights the challenges encountered by rural health departments that often face a double disparity (i.e., higher rates of risk factors coupled with limited capacity) (96). …”