This week’s readings discussed rural health in comparison to urban health and health care disparities and inequalities concerning location. I particularly liked David Hartley’s article, “Rural Health Disparities, Population Health, and Rural Culture,” in the way it discusses the current transition from focusing on rural health to population health, health care inequalities which are often due to location, the background context he includes, and the cultural aspects of rural health he writes about. Hartley begins by examining how the field of rural health has grown and developed over the past 30 years. Rural health research and policy has become more and more established over the last few decades; there is now more research and publications in journals than ever before. In fact, the rural health field now includes dental medicine, mental medicine, and emergency medical services as well. Hartley then goes on to explain the specifics of rural health research; typically, data is presented to initially determine if there is any significant difference between a rural and urban environment or service. This data usually detects differences in terms of utilization of health care services, government spending, and geographic distribution of providers and services. However, the tables may be turning and the focus on rural health is seemingly transitioning to population health.

According to David Kindig and Greg Stoddart, population health is defined as “an approach that focuses on interrelated conditions and factors that influence the health of populations over the life course, identifies systematic variations in their patterns of occurrence, and applies the resulting knowledge to develop and implement policies and actions to improve the health and well being of those populations.” In a recent survey amongst rural health experts and physicians, “access to health services” was overwhelmingly ranked as the number one priority; conversely, the survey participants also ranked diabetes, mental health, oral health, and tobacco higher than ever before and as serious health concerns too. I don’t think the issue of “place” will ever completely go away as a priority in medicine and health care, but it is clear that the focus of many health care professionals is shifting from the differences between urban and rural health to population health. I guess we will just have to watch and see as more research is conducted and reforms and policies are brought forward regarding interventions and rural regions.




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