Rural Public Health Financing

Meit, Michael; Ettaro, Lorraine; Hamlin, Benjamin N.; Piya, Bhumika

doi:10.1097/01.phh.0000349738.73619.f5

Cited by 13 publications

(8 citation statements)

References 1 publication

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“…We know of no comparable evidence regarding tobacco regulatory resources, but that possibility merits review especially regarding vulnerable populations such as women of reproductive age and pregnant women. Given a more limited public health infrastructure among rural communities [40], a combination of federal and state resources is likely to be necessary to eliminate these urban-rural disparities through increased tobacco regulatory efforts, such as increased excise taxes [41], clean indoor air policies in workplaces and other public venues [15, 39, 42–44], and targeted public health messaging [35, 45–46], particularly to rural women of childbearing age and healthcare providers who care for them.…”

Section: Discussionmentioning

confidence: 99%

Smoking prevalence and trends among a U.S. national sample of women of reproductive age in rural versus urban settings

et al. 2018

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U.S. smoking prevalence is declining at a slower rate in rural than urban settings and contributing to regional health disparities. Cigarette smoking among women of reproductive age is particularly concerning due to the potential for serious maternal and infant adverse health effects should a smoker become pregnant. The aim of the present study was to examine whether this rural-urban disparity impacts women of reproductive age (ages 15–44) including pregnant women. Data came from the ten most recent years of the U.S. National Survey on Drug Use and Health (2007–2016). We estimated prevalence of current smoking and nicotine dependence among women categorized by rural-urban residence, pregnancy status, and trends using chi-square testing and multivariable modeling while adjusting for common risk factors for smoking. Despite overall decreasing trends in smoking prevalence, prevalence was higher among rural than urban women of reproductive age overall (χ2(1) = 579.33, p < .0001) and among non-pregnant (χ2(1) = 578.0, p < .0001) and pregnant (χ2(1) = 79.69, p < .0001) women examined separately. An interaction between residence and pregnancy status showed adjusted odds of smoking among urban pregnant compared to non-pregnant women (AOR = .58, [.53 –.63]) were lower than those among rural pregnant compared to non-pregnant women (AOR = 0.75, [.62 –.92]), consistent with greater pregnancy-related smoking cessation among urban pregnant women. Prevalence of nicotine dependence was also higher in rural than urban smokers overall (χ2(2) = 790.42, p < .0001) and among non-pregnant (χ2(2) = 790.58, p < .0001) and pregnant women examined separately (χ2(2) = 63.69, p < .0001), with no significant changes over time. Associations involving residence and pregnancy status remained significant in models adjusting for covariates (ps < 0.05). Results document greater prevalence of smoking and nicotine dependence and suggest less pregnancy-related quitting among rural compared to urban women, disparities that have potential for direct, multi-generational adverse health impacts.

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Section: Discussionmentioning

confidence: 99%

Smoking prevalence and trends among a U.S. national sample of women of reproductive age in rural versus urban settings

et al. 2018

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“…Other organizations had the motivation to apply for accreditation but not the staff or financial resources to do so. 7 As with any effort, whether it is a community health assessment, 8 a QI project, 9 or a standards-based accreditation program, 10 it is important to assess the readiness and motivation for change. The PHAB Readiness Checklist is a useful tool.…”

Section: Discussionmentioning

confidence: 99%

A Study of Incentives to Support and Promote Public Health Accreditation

Thielen

Leff

Corso

et al. 2014

Journal of Public Health Management and Practice

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Context Accreditation of public health agencies through the Public Health Accreditation Board is voluntary. Incentives that encourage agencies to apply for accreditation have been suggested as important factors in facilitating participation by state and local agencies. Objective The project describes both current and potential incentives that are available at the federal, state, and local levels. Design Thirty-nine key informants from local, state, tribal, federal, and academic settings were interviewed from March through May 2012. Through open-ended interviews, respondents were asked about incentives that were currently in use in their settings and incentives they thought would help encourage participation in Public Health Accreditation Board accreditation. Results Incentives currently in use by public health agencies based on interviews include (1) financial support, (2) legal mandates, (3) technical assistance, (4) peer support workgroups, and (5) state agencies serving as role models by seeking accreditation themselves. Key informants noted that state agencies are playing valuable and diverse roles in providing incentives for accreditation within their own states. Key informants also identified the Centers for Disease Control and Prevention and other players, such as private foundations, public health institutes, national and state associations, and academia as providing both technical and financial assistance to support accreditation efforts. Conclusions State, tribal, local, and federal agencies, as well as related organizations can play an important role by providing incentives to move agencies toward accreditation.

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“…Recruitment and retention of staff are challenged by a shortage of funding and lack of support from elected officials (Meit et al, 2012). As a result of this lack of funding and support, many rural health departments may not meet the recommended infrastructure guidelines to be well-equipped in the event of an outbreak (Meit et al, 2008). Small LHDs are also less likely to have an emergency plan or public health staff trained in emergency preparedness (NACCHO, 2017).…”

Section: Public Health Capacitymentioning

confidence: 99%

Voices from the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C

Williamson¹,

Pearson²,

Burgess³

et al. 2021

Journal of Health and Human Services Administration

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Rural areas of the United States may be vulnerable to an HIV or hepatitis C (HCV) outbreak among persons who inject drugs. We conducted semi-structured interviews with 36 state and local public health professionals from six rural states to gain an understanding of the challenges rural communities face and strategies they are using to prepare for, identify, and respond to HIV and/or HCV outbreaks due to intravenous drug use. Key informants described inadequate funding, insufficient staffing, limited health care infrastructure, and other factors as limiting the public health capacity of rural areas. Promising prevention, surveillance, and treatment strategies in rural areas included the use of mobile treatment units, telemedicine approaches, and community education initiatives to overcome resistance to evidence-based harm reduction programs.

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Rural Public Health Financing

Cited by 13 publications

References 1 publication

Smoking prevalence and trends among a U.S. national sample of women of reproductive age in rural versus urban settings

Smoking prevalence and trends among a U.S. national sample of women of reproductive age in rural versus urban settings

A Study of Incentives to Support and Promote Public Health Accreditation

Voices from the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C

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