INSIGHT & INSPIRATION FROM APHA’S 2012 MIDYEAR MEETING

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Survive All In This Friends Prevention, Strategies & Thrive Together For Health Opportunity & Equity For Health 4PREVENTION, OPPORTUNITY & EQUITY: STAYING TRUE TO PUBLIC HEALTH VALUES “We think we can make a difference in closing the gap by the medical model — and I think it’s important to recognize we don’t need to be an adversary to the medical model — but the medical model is not going to close the gap in excess death. It has to be one based upon social justice and the notion of human rights.” — Adewale Troutman, APHA President, <strong>2012</strong>-2013
29 Survive All In This Friends Prevention, Strategies & Thrive Together For Health Opportunity & Equity for Health Keep the Focus on Inequities “Child health is rural wealth.” That’s what the banner reads in an old picture from 1923 of the country’s first rural health department, which actually began as a pilot project to see if it was possible to bring the urban protections of public health to a rural setting. The session speaker behind the picture was Michael Meit, co-director of the Walsh Center for Rural Health Analysis at the University of Chicago, who reminded attendees that rural communities continue to face barriers to good health. And on the flip side, public health workers continue to face barriers in reaching rural communities. “The challenge that we face in rural public health is how do we provide equitable public health services — basic public health services — to a population that is dispersed,” he asked. First, what is rural? There are more than 70 federal definitions of rural, Meit said, from small towns to frontier, which is defined as six or fewer people per square mile. About 20 percent of the U.S. population lives in rural areas, and most of the nation’s landscape is rural even though most people live in urban settings. Rural residents face a number of social determinants that impact their health, from lack of access to health care and public health services to isolation and poor local economies. Meit noted that per capita income is about $10,000 less in rural areas than in urban areas; about 31 percent of food assistance recipients live in rural communities; and 48 of the 50 U.S. counties with the highest child poverty rates are rural. Meit said that disparities worsen even more when taking into account the racial and ethnic make-up of rural regions. Hispanics are the nation’s fastest growing rural population; the American South is home to large rural black communities; and the Plains and southwestern states are home to large American Indian communities. All such groups suffer from documented disparities in access and disease rates. “A lot of the health disparities we see are an interplay between geography and race and ethnicity,” he said.
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INSIGHT & INSPIRATION FROM APHA’S 2012 MIDYEAR MEETING

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