Unmasking Problems in Rural Health Planning

Separating regional health statistics into smaller geographic segments will help local planning agencies identify and deal with health needs of rural people. National and regional averages for key health planning variables mask rural problems because these variables differ widely within and among regions. Further, health service areas (HSAs) are more rural than the national average would indicate. Better health care planning and delivery require the following adjustments: (1) use of disaggregated data, (2) flexibility in regulations, (3) adjustment of funding formulas, (4) establishment of subarea councils, (5) identification of major HSA rural types, and (6) improvement of data for small rural areas

Open-Country Poverty in a Relatively Affluent Area -- The East North Central States

Poverty among open-country households in the East North Central States--11 percent--was slightly above incidence found among U.S. whites in general. Incidence of poverty was greatest among the aged, disabled, and small farmers of all ages who made farming their major source of earnings. Eighty-seven percent of the respondent households in this 1967 survey had earnings. Most respondents were nonfarmers. Although 42 percent received some income from a farm, only 12 percent got the major portion of their earnings from this source. Seventy-two percent of poor households with heads under age 45, and 57 percent of those with heads aged 45-64 reported no income other than earnings, interest, or dividends. Even more received no welfare payments. In this area, where two-fifths of all houses were built before 1901, substandard housing was prevalent among the poor

A Profile of U.S. Comprehensive Health Planning Areas

Excerpt from the report preface: The rural health problem is one of identifying uniquely rural characteristics and of identifying health problem solutions in light of these rural characteristics and needs. It may be divided into three parts: (1) adapting health care delivery systems to meet the needs of a sparse and dispersed population, often with transportation barriers; (2) making urban decisionmakers aware of rural problems, needs, and attitudes, so they will adequately provide for rural areas; and (3) reaching the rural population effectively to educate and motivate them to make the best use of the services provided. This report provides data that may help solve some of these rural problems

Critical Health Manpower Shortage Areas: Their Impact on Rural Health Planning

This report describes the 673 medical Critical Health Manpower Shortage Areas (CHMSAs) listed by the Federal Register for February 25, 1975, in terms of the Comprehensive Health Planning (CHP) areas where they are located. It describes how the Rural Health Initiative program is designed to cope with the shortage problem and how this program is related to the work of the Health Service Agencies (HSAs) that are succeeding the CHP councils under the new health planning law. A method for relating CHPs and HSAs in specific areas is indicated. Of the 416 CHPs into which the United States (excluding Alaska and the New England States) was divided as of May 1973, 269 had one or more CHMSAs. In 99, the CHMSAs covered over one-third of the land area. CHPs with very large urbanized areas had relatively few CHMSAs and only 24 CHMSAs contained an urbanized area. On the average, about the same proportion of CHP areas with Standard Metropolitan Statistical Areas (SMSAs) had CHMSAs as non-SMSA type CHPs--63 percent v. 66 percent. CHP areas with socioeconomic variables deviating adversely from the average had a high proportion of CHMSAs. In 112 CHPs, all of the CHMSAs were outside a circle of 50-mile radius drawn around urbanized areas of 100,000 or more; in 102, part of the CHMSAs were outside the circle. Tests made on CHPs with a high probability that CHMSA designation might have been overlooked found few instances of potential omission. However, findings suggest that possibly different criteria are needed for medical service areas characterized by a large land area with very few residents