Public health

Publications

Alphabetical list. You can also view by publication date.

A Rural Socioeconomic Risk and Resiliency Inventory and Associated Health Outcomes (Final Report)
Date: 03 / 2011
Author(s): Joel A. Halverson, Michael Hendryx
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Environmental & agricultural health, Public health
Rural areas, especially in the Southeast, Appalachia and parts of the West, have worse VRI (Vulnerability and Resiliency Index) scores which are a measure of six socioeconomic indicators across counties in the United States.
Determining Satisfaction with Access and Financial Aspects of Care for Persons Exposed to Libby Amphibole Asbestos: Rural and National Environmental Policy Implications
Date: 05 / 2011
Author(s): Charlene A.Winters, Wade Hill, Sandra W. Kuntz, Clarann Weinert, Kimberly Rowse, Tanis Hernandez, Brad Black
Topics: Environmental & agricultural health, Public health
Citation: Journal of Environmental and Public Health
Volume 2011, Article ID 789514
The rural community of Libby, Montana is the epidemiological epicenter of asbestos-related disease with mortality rates 40–80 times higher when compared to rates in Montana and the USA.
Effect of Market Reform on Rural Public Health Departments
Date: 01 / 2000
Author(s): Rebecca Slifkin, Pam Silberman, Susan Reif
Research center: North Carolina Rural Health Research and Policy Analysis Center
Topic: Public health
This study seeks to determine how rural health departments and populations they serve have been affected by recent health system changes, especially Medicaid managed care.
Environmental Workforce Characteristics in the Rural Public Health Sector (Final Report)
Date: 12 / 2011
Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
This project analyzed the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services. Environmental risks to rural populations are understudied relative to urban areas despite increasing recognition that rural populations are potentially exposed to these risks from agricultural, mining, industrial, or other sources. These environmental risks and associated health problems carry corresponding implications for public health programs and services, and highlight the need for a rural public health workforce that includes appropriate environmental health specialists.
Environmental Workforce Characteristics in the Rural Public Health Sector (Policy Brief)
Date: 12 / 2011
Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
This project analyzed the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services. Environmental risks to rural populations are understudied relative to urban areas despite increasing recognition that rural populations are potentially exposed to these risks from agricultural, mining, industrial or other sources. These environmental risks and associated health problems carry corresponding implications for public health programs and services, and highlight the need for a rural public health workforce that includes appropriate environmental health specialists.
Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
Date: 06 / 2008
Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya
Research center: Walsh Center for Rural Health Analysis
Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health
Final Report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state and local level public health infrastructure.
Key Environmental Health Competencies for Rural Primary Care Providers (Final Report)
Date: 03 / 2010
Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Physicians, Public health
The purpose of this study was to develop a set of basic environmental health competencies that are needed by all rural primary care providers to direct health care and education policy.
Local Health Districts and the Public Health Workforce: A Case Study of Wyoming and Idaho
Date: 2001
Author(s): Richardson M, Casey S, Rosenblatt RA
Research center: WWAMI Rural Health Research Center
Topics: Public health, Workforce
Citation: Journal of Public Health Management Practice, 7(1):37-48
This study of personnel in local health departments (LHDs) focused on two predominantly rural states: Idaho and Wyoming. Although in the same region of the country, the structure of local public health is different in each state. Idaho's regionalized LHDs are relatively autonomous, whereas Wyoming's are county based, with many public health functions retained at the state level. The majority of professionals are nurses followed by environmental health workers and sanitarians, similar to data reported nationally. With increased emphasis on core public health functions of policy, assurance, and assessment, rural LHDs will be challenged to redirect the functions of their workforce.
Local Public Health at the Crossroads: The Structure of Health Departments in Rural Areas (Issue Brief)
Date: 03 / 2006
Author(s): Anthony Wellever
Research center: ORHP-funded Individual Grantees
Topic: Public health
Overview of findings from a study of the structure of rural local public health departments. Includes policy recommendations.
Local Public Health at the Crossroads: The Structure of Health Departments in Rural Areas (Report)
Date: 03 / 2006
Author(s): Anthony Wellever
Research center: ORHP-funded Individual Grantees
Topic: Public health
Reports the results of a study of the structure of local health departments in rural areas. Includes case studies describing the structure of local health departments in rural areas in six geographically disparate states: Arizona, Georgia, Kansas, Louisiana, Pennsylvania, and Washington.
Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties (Final Report)
Date: 06 / 2011
Author(s): Joel Halverson, Cheryl Brown, Melissa Olfert, Melissa Ahern, Christiaan Abildso
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
Rural counties are disproportionately associated with high food insecurity risk relative to urban counties. Programs and policies may focus on improving food availability and access for rural populations. More research, with multivariate analyses across regions, can shed additional light on the impact of food insecurity on the health of the population, especially for those living in rural areas.
Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties (Policy Brief)
Date: 06 / 2011
Author(s): Joel Halverson, Cheryl Brown, Melissa Olfert, Melissa Ahern, Christian Abildso
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
This project will examine the characteristics of food security and food availability across the rural-urban continuum. The study will test the hypotheses that food insecurity will differ significantly between rural and urban counties in the US with rural areas experiencing more adverse conditions; and that there will be a significant relationship between food insecurity, food availability and selected adverse health outcomes in non-metropolitan counties in the US.
Place-based Policies and Public Health: The Road to Healthy Rural People and Places
Date: 03 / 2011
Author(s): Keith J. Mueller, A. Clinton MacKinney, Mario Gutierrez, Jocelyn Richgels
Research center: Rural Policy Analysis and Applications
Topics: Health policy, Public health
Identifies how the Patient Protection and Affordable Care Act of 2010 (ACA) can influence the determinants of health and contribute to the prosperity, equity, sustainability, and livability of rural places.
Pollution Sources and Mortality Rates across Rural-Urban Areas in the United States (Final Report)
Date: 02 / 2010
Author(s): Michael Hendryx, Evan Fedorko, Joel Halverson
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
Report Number: Final Report #1
Rural counties contain more than 65,000 EPA-recognized point pollution sources. A greater density of water and air pollution sources in rural counties is associated with higher cancer mortality rates adjusting for other risks. Rural areas also experience mortality risks in association with coal mining activity.
Pollution Sources and Mortality Rates across Rural-Urban Areas in the United States (Policy Brief)
Date: 02 / 2010
Author(s): Michael Hendryx, Evan Fedorko, Joel Halverson
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
Report Number: Policy Brief #1
Rural counties contain more than 65,000 EPA-recognized point pollution sources. A greater density of water and air pollution sources in rural counties is associated with higher cancer mortality rates adjusting for other risks. Rural areas also experience mortality risks in association with coal mining activity.
Psychosocial Health Status of Persons Seeking Treatment for Exposure to Libby Amphibole Asbestos
Date: 2011
Author(s): Clarann Weinert, Wade G. Hill, Charlene A.Winters, SandraW. Kuntz, Kimberly Rowse, Tanis Hernandez, Brad Black, Shirley Cudney
Research center: ORHP-funded Individual Grantees
Topics: Environmental & agricultural health, Public health
Citation: International Scholarly Research Network, ISRN Nursing, Volume 2011, 11 pages
A cross-sectional exploratory study was conducted to describe the psychosocial health status of persons seeking health care for exposure to Libby amphibole asbestos.
PTSD and Substance Use: Unrecognized Sequelae of Bioterrorism in Primary Care Providers
Date: 2006
Author(s): Jennie C. I. Tsao, Aram Dobalian, Brenda A. Wiens, Julius A. Gylys, Art Clawson, Robert Brooks
Research center: ORHP-funded Individual Grantees
Topics: Emergency preparedness, Mental health, Public health, Substance abuse
Citation: Southern Medical Journal, 99(8), 817-822
Reports the results of a study that looked at rural primary care providers' knowledge of likely mental disorders, their risk factors, and preferred treatment options following a public health emergency.
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 1
Date: 2003
Author(s): Larry D. Gamm, Linnae L. Hutchison, Betty J. Dabney, Alicia M. Dorsey, eds.
Research center: Southwest Rural Health Research Center
Topics: Health promotion and disease prevention, Healthy People 2010 (Rural), Public health
Brief overviews of the top rural health concerns and objectives associated with Healthy People 2010 focus areas, including, Access to Quality Health Services (Insurance, Primary Care, and EMS); Cancer; Diabetes; Heart Disease and Stroke; Maternal, Infant, and Child Health; Mental Health and Mental Disorders; Nutrition and Overweight Concerns; Oral Health; Substance Abuse; and Tobacco Use. Also included are references to key literature about these concerns, and descriptions of models for practice that rural communities can draw upon to achieve key Healthy People 2010 objectives.
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 2
Date: 2003
Author(s): Larry D. Gamm, Linnae L. Hutchison, Betty J. Dabney, Alicia M. Dorsey, eds.
Research center: Southwest Rural Health Research Center
Topics: Health promotion and disease prevention, Healthy People 2010 (Rural), Public health
Detailed literature reviews and associated references for the top rural health concerns addressed in Vol. 1 of Rural Healthy People 2010.
Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 3
Date: 04 / 2004
Author(s): Larry D. Gamm, Linnae L. Hutchison, eds.
Research center: Southwest Rural Health Research Center
Topics: Health promotion and disease prevention, Health services, Healthy People 2010 (Rural), Long term care, Physical abuse and domestic violence, Public health
Report Number: Updated February 2005
Includes the overview of research and accompanying models for practice on 5 new focus areas in Rural Healthy People 2010, along with the more detailed literature reviews for each. The focus areas are: Access to Quality Health Services in Rural Areas/Access to Long-term Care; Educational and Community-based Programs in Rural Areas; Immunizations and Infectious Diseases in Rural Areas; Injury and Violence Prevention in Rural Areas; and Rural Public Health Infrastructure.
Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding (Policy Brief)
Date: 06 / 2008
Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya
Research center: Walsh Center for Rural Health Analysis
Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health
Report Number: W Series No. 14
The purpose of this study was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes. A central hypothesis was that the availability of federal funding for chronic disease prevention and health promotion activities may vary based on state and local public health infrastructural differences.
Rural Public Health Infrastructure: Case Studies to Assess the Impact of Structure on Service Delivery
Date: 01 / 2006
Author(s): Leigh Ann White, Lauren Silver
Research center: Walsh Center for Rural Health Analysis
Topic: Public health
The purpose of this study is to contribute to a more thorough understanding of how public health governance affects how states structure and organize the delivery of public health services, and how this, in turn, influences the strategies adopted for meeting community public health needs in rural areas. Using a case study approach, the study examined three themes: 1) lines of reporting and accountability among public health entities, 2) provision of public health services, and 3) public health funding for localities. This work suggests that it would be of value to develop a comprehensive profile of state' public health systems, which would include specific aspects of each state's public health infrastructure, as well as community population and health statistics. Report available on request.
Rural Public Health Policy Models to Address an Evolving Environmental Asbestos Disaster
Date: 2009
Author(s): Sandra W. Kuntz, Charlene A.Winters, Wade G.Hill, Clarann Weinert, Kimberly Rowse,Tanis Hernandez, Brad Black
Research center: ORHP-funded Individual Grantees
Topics: Environmental & agricultural health, Public health
Citation: Public Health Nursing Vol. 26 No. 1, pp. 70�78, 2009
Describes the history and outcomes of asbestos exposure in the Libby community and discusses 3 models that provide public health policy insights related to rural health and health care for a community affected by both a sentinel and ongoing environmental event. The foundation for the publication was our work with the Center for Asbestos Related Disease in Libby and our study funded by the Office of Rural Health Policy.
Rural Socioeconomic Vulnerability and Resiliency Index and Associated Health Outcomes (Policy Brief)
Date: 07 / 2011
Author(s): Joel A. Halverson, Michael Hendryx
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
Rural areas, especially in the Southeast, Appalachia and parts of the West, have worse VRI (Vulnerability and Resiliency Index) scores which are a measure of six socioeconomic indicators across counties in the United States. Better VRI scores were associated with better health outcomes (lower heart disease, cancer, and stroke death rates) across the rural-urban continuum. These analyses provide evidence to support the development of programs and policies that foster educational development, and economic diversity and vitality, as means of public health improvement, especially in rural areas in selected regions of the country.
Rural-Urban Differences in the Public Health Workforce: Findings From Local Health Departments in three Rural Western States
Date: 07 / 2002
Author(s): Rosenblatt RA, Casey S, Richardson M
Research center: WWAMI Rural Health Research Center
Topics: Public health, Workforce
Citation: American Journal of Public Health, 92(7):1102-1105
Most local health departments or districts are small and rural; two thirds of the nation's 2832 local health departments serve populations smaller than 50,000 people. Rural local health departments have small staffs and slender budgets, yet they are expected to provide a wide array of services during a period when the health care system of which they are a part is undergoing change.
This study provided quantitative, population-based data on the supply and composition of the rural public health workforce in 3 extremely rural states: Alaska, Montana, and Wyoming. The study focused on the relative supply of personnel in the principal public health occupational categories, differences across states in staffing levels, and difficulties experienced in recruiting and retaining personnel.
Toxics Release Inventory Discharges and Population Health Outcomes in Rural and Urban Areas of the United States (Final Report)
Author(s): Michael Hendryx, Evan Fedorko, Juhua Luo
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
The current study examines whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program were associated with population mortality rates and birth outcomes for both rural and urban populations. We also examined whether rural and urban areas characterized by poor socioeconomic status or higher percentages of racial minorities had greater TRI releases. Health outcomes included age-adjusted CDC mortality rates for cancer, respiratory, cardiovascular, and total causes, and NCHS birth outcomes including low birth weight, preterm births and birth defects. Rural counties are defined as non-metropolitan based on rural-urban continuum codes. The results show significantly higher adjusted total mortality rates associated with greater air and water releases in both rural and urban counties, after controlling for the effects of other risk variables. Effects were found in rural areas for total, cardiovascular, and (marginally) cancer mortality outcomes. We found that counties with higher percentages of African American populations had more non-zero releases, but did not find this for populations characterized by greater Native American populations, lower income levels or higher poverty. We did not find consistent evidence for higher TRI releases being related to poorer birth outcomes. Suggestions for reducing emissions, further research to understand human health impacts, and improving rural health care are presented.
Toxics Release Inventory Discharges and Population Health Outcomes in Rural and Urban Areas of the United States (Policy Brief)
Author(s): Michael Hendryx, Evan Fedorko, Juhua Luo
Research center: West Virginia Rural Health Research Center
Topics: Environmental & agricultural health, Public health
Examined whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program were associated with population mortality rates for both rural and urban populations.
Water Fluoridation and Dental Health Indicators in Rural and Urban Areas of the United States
Date: 11 / 2011
Author(s): Michael Hendryx, Constance Weiner, Matthew Gurka
Research center: West Virginia Rural Health Research Center
Topics: Dental health, Environmental & agricultural health, Public health
This study investigated the availability of fluoridated water across urban-rural settings, and relates measures of fluoride availability to national survey measures of dental health in adults and children.

Topics Centers Researchers Other Resources Search		Public health Publications Alphabetical list. You can also view by publication date. A Rural Socioeconomic Risk and Resiliency Inventory and Associated Health Outcomes (Final Report) Date: 03 / 2011 Author(s): Joel A. Halverson, Michael Hendryx Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Environmental & agricultural health, Public health Rural areas, especially in the Southeast, Appalachia and parts of the West, have worse VRI (Vulnerability and Resiliency Index) scores which are a measure of six socioeconomic indicators across counties in the United States. Determining Satisfaction with Access and Financial Aspects of Care for Persons Exposed to Libby Amphibole Asbestos: Rural and National Environmental Policy Implications Date: 05 / 2011 Author(s): Charlene A.Winters, Wade Hill, Sandra W. Kuntz, Clarann Weinert, Kimberly Rowse, Tanis Hernandez, Brad Black Topics: Environmental & agricultural health, Public health Citation: Journal of Environmental and Public Health Volume 2011, Article ID 789514 The rural community of Libby, Montana is the epidemiological epicenter of asbestos-related disease with mortality rates 40–80 times higher when compared to rates in Montana and the USA. Effect of Market Reform on Rural Public Health Departments Date: 01 / 2000 Author(s): Rebecca Slifkin, Pam Silberman, Susan Reif Research center: North Carolina Rural Health Research and Policy Analysis Center Topic: Public health This study seeks to determine how rural health departments and populations they serve have been affected by recent health system changes, especially Medicaid managed care. Environmental Workforce Characteristics in the Rural Public Health Sector (Final Report) Date: 12 / 2011 Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health This project analyzed the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services. Environmental risks to rural populations are understudied relative to urban areas despite increasing recognition that rural populations are potentially exposed to these risks from agricultural, mining, industrial, or other sources. These environmental risks and associated health problems carry corresponding implications for public health programs and services, and highlight the need for a rural public health workforce that includes appropriate environmental health specialists. Environmental Workforce Characteristics in the Rural Public Health Sector (Policy Brief) Date: 12 / 2011 Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health This project analyzed the environmental workforce characteristics of the rural public health sector to inform policy relative to coordination of rural environmental health services. Environmental risks to rural populations are understudied relative to urban areas despite increasing recognition that rural populations are potentially exposed to these risks from agricultural, mining, industrial or other sources. These environmental risks and associated health problems carry corresponding implications for public health programs and services, and highlight the need for a rural public health workforce that includes appropriate environmental health specialists. Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report) Date: 06 / 2008 Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya Research center: Walsh Center for Rural Health Analysis Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health Final Report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state and local level public health infrastructure. Key Environmental Health Competencies for Rural Primary Care Providers (Final Report) Date: 03 / 2010 Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Physicians, Public health The purpose of this study was to develop a set of basic environmental health competencies that are needed by all rural primary care providers to direct health care and education policy. Local Health Districts and the Public Health Workforce: A Case Study of Wyoming and Idaho Date: 2001 Author(s): Richardson M, Casey S, Rosenblatt RA Research center: WWAMI Rural Health Research Center Topics: Public health, Workforce Citation: Journal of Public Health Management Practice, 7(1):37-48 This study of personnel in local health departments (LHDs) focused on two predominantly rural states: Idaho and Wyoming. Although in the same region of the country, the structure of local public health is different in each state. Idaho's regionalized LHDs are relatively autonomous, whereas Wyoming's are county based, with many public health functions retained at the state level. The majority of professionals are nurses followed by environmental health workers and sanitarians, similar to data reported nationally. With increased emphasis on core public health functions of policy, assurance, and assessment, rural LHDs will be challenged to redirect the functions of their workforce. Local Public Health at the Crossroads: The Structure of Health Departments in Rural Areas (Issue Brief) Date: 03 / 2006 Author(s): Anthony Wellever Research center: ORHP-funded Individual Grantees Topic: Public health Overview of findings from a study of the structure of rural local public health departments. Includes policy recommendations. Local Public Health at the Crossroads: The Structure of Health Departments in Rural Areas (Report) Date: 03 / 2006 Author(s): Anthony Wellever Research center: ORHP-funded Individual Grantees Topic: Public health Reports the results of a study of the structure of local health departments in rural areas. Includes case studies describing the structure of local health departments in rural areas in six geographically disparate states: Arizona, Georgia, Kansas, Louisiana, Pennsylvania, and Washington. Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties (Final Report) Date: 06 / 2011 Author(s): Joel Halverson, Cheryl Brown, Melissa Olfert, Melissa Ahern, Christiaan Abildso Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health Rural counties are disproportionately associated with high food insecurity risk relative to urban counties. Programs and policies may focus on improving food availability and access for rural populations. More research, with multivariate analyses across regions, can shed additional light on the impact of food insecurity on the health of the population, especially for those living in rural areas. Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties (Policy Brief) Date: 06 / 2011 Author(s): Joel Halverson, Cheryl Brown, Melissa Olfert, Melissa Ahern, Christian Abildso Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health This project will examine the characteristics of food security and food availability across the rural-urban continuum. The study will test the hypotheses that food insecurity will differ significantly between rural and urban counties in the US with rural areas experiencing more adverse conditions; and that there will be a significant relationship between food insecurity, food availability and selected adverse health outcomes in non-metropolitan counties in the US. Place-based Policies and Public Health: The Road to Healthy Rural People and Places Date: 03 / 2011 Author(s): Keith J. Mueller, A. Clinton MacKinney, Mario Gutierrez, Jocelyn Richgels Research center: Rural Policy Analysis and Applications Topics: Health policy, Public health Identifies how the Patient Protection and Affordable Care Act of 2010 (ACA) can influence the determinants of health and contribute to the prosperity, equity, sustainability, and livability of rural places. Pollution Sources and Mortality Rates across Rural-Urban Areas in the United States (Final Report) Date: 02 / 2010 Author(s): Michael Hendryx, Evan Fedorko, Joel Halverson Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health Report Number: Final Report #1 Rural counties contain more than 65,000 EPA-recognized point pollution sources. A greater density of water and air pollution sources in rural counties is associated with higher cancer mortality rates adjusting for other risks. Rural areas also experience mortality risks in association with coal mining activity. Pollution Sources and Mortality Rates across Rural-Urban Areas in the United States (Policy Brief) Date: 02 / 2010 Author(s): Michael Hendryx, Evan Fedorko, Joel Halverson Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health Report Number: Policy Brief #1 Rural counties contain more than 65,000 EPA-recognized point pollution sources. A greater density of water and air pollution sources in rural counties is associated with higher cancer mortality rates adjusting for other risks. Rural areas also experience mortality risks in association with coal mining activity. Psychosocial Health Status of Persons Seeking Treatment for Exposure to Libby Amphibole Asbestos Date: 2011 Author(s): Clarann Weinert, Wade G. Hill, Charlene A.Winters, SandraW. Kuntz, Kimberly Rowse, Tanis Hernandez, Brad Black, Shirley Cudney Research center: ORHP-funded Individual Grantees Topics: Environmental & agricultural health, Public health Citation: International Scholarly Research Network, ISRN Nursing, Volume 2011, 11 pages A cross-sectional exploratory study was conducted to describe the psychosocial health status of persons seeking health care for exposure to Libby amphibole asbestos. PTSD and Substance Use: Unrecognized Sequelae of Bioterrorism in Primary Care Providers Date: 2006 Author(s): Jennie C. I. Tsao, Aram Dobalian, Brenda A. Wiens, Julius A. Gylys, Art Clawson, Robert Brooks Research center: ORHP-funded Individual Grantees Topics: Emergency preparedness, Mental health, Public health, Substance abuse Citation: Southern Medical Journal, 99(8), 817-822 Reports the results of a study that looked at rural primary care providers' knowledge of likely mental disorders, their risk factors, and preferred treatment options following a public health emergency. Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 1 Date: 2003 Author(s): Larry D. Gamm, Linnae L. Hutchison, Betty J. Dabney, Alicia M. Dorsey, eds. Research center: Southwest Rural Health Research Center Topics: Health promotion and disease prevention, Healthy People 2010 (Rural), Public health Brief overviews of the top rural health concerns and objectives associated with Healthy People 2010 focus areas, including, Access to Quality Health Services (Insurance, Primary Care, and EMS); Cancer; Diabetes; Heart Disease and Stroke; Maternal, Infant, and Child Health; Mental Health and Mental Disorders; Nutrition and Overweight Concerns; Oral Health; Substance Abuse; and Tobacco Use. Also included are references to key literature about these concerns, and descriptions of models for practice that rural communities can draw upon to achieve key Healthy People 2010 objectives. Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 2 Date: 2003 Author(s): Larry D. Gamm, Linnae L. Hutchison, Betty J. Dabney, Alicia M. Dorsey, eds. Research center: Southwest Rural Health Research Center Topics: Health promotion and disease prevention, Healthy People 2010 (Rural), Public health Detailed literature reviews and associated references for the top rural health concerns addressed in Vol. 1 of Rural Healthy People 2010. Rural Healthy People 2010: A Companion Document to Healthy People 2010. Volume 3 Date: 04 / 2004 Author(s): Larry D. Gamm, Linnae L. Hutchison, eds. Research center: Southwest Rural Health Research Center Topics: Health promotion and disease prevention, Health services, Healthy People 2010 (Rural), Long term care, Physical abuse and domestic violence, Public health Report Number: Updated February 2005 Includes the overview of research and accompanying models for practice on 5 new focus areas in Rural Healthy People 2010, along with the more detailed literature reviews for each. The focus areas are: Access to Quality Health Services in Rural Areas/Access to Long-term Care; Educational and Community-based Programs in Rural Areas; Immunizations and Infectious Diseases in Rural Areas; Injury and Violence Prevention in Rural Areas; and Rural Public Health Infrastructure. Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding (Policy Brief) Date: 06 / 2008 Author(s): Michael Meit, Lorraine Ettaro, Benjamin Hamlin, Bhumika Piya Research center: Walsh Center for Rural Health Analysis Topics: Chronic diseases and conditions, Health care financing, Health promotion and disease prevention, Public health Report Number: W Series No. 14 The purpose of this study was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes. A central hypothesis was that the availability of federal funding for chronic disease prevention and health promotion activities may vary based on state and local public health infrastructural differences. Rural Public Health Infrastructure: Case Studies to Assess the Impact of Structure on Service Delivery Date: 01 / 2006 Author(s): Leigh Ann White, Lauren Silver Research center: Walsh Center for Rural Health Analysis Topic: Public health The purpose of this study is to contribute to a more thorough understanding of how public health governance affects how states structure and organize the delivery of public health services, and how this, in turn, influences the strategies adopted for meeting community public health needs in rural areas. Using a case study approach, the study examined three themes: 1) lines of reporting and accountability among public health entities, 2) provision of public health services, and 3) public health funding for localities. This work suggests that it would be of value to develop a comprehensive profile of state' public health systems, which would include specific aspects of each state's public health infrastructure, as well as community population and health statistics. Report available on request. Rural Public Health Policy Models to Address an Evolving Environmental Asbestos Disaster Date: 2009 Author(s): Sandra W. Kuntz, Charlene A.Winters, Wade G.Hill, Clarann Weinert, Kimberly Rowse,Tanis Hernandez, Brad Black Research center: ORHP-funded Individual Grantees Topics: Environmental & agricultural health, Public health Citation: Public Health Nursing Vol. 26 No. 1, pp. 70�78, 2009 Describes the history and outcomes of asbestos exposure in the Libby community and discusses 3 models that provide public health policy insights related to rural health and health care for a community affected by both a sentinel and ongoing environmental event. The foundation for the publication was our work with the Center for Asbestos Related Disease in Libby and our study funded by the Office of Rural Health Policy. Rural Socioeconomic Vulnerability and Resiliency Index and Associated Health Outcomes (Policy Brief) Date: 07 / 2011 Author(s): Joel A. Halverson, Michael Hendryx Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health Rural areas, especially in the Southeast, Appalachia and parts of the West, have worse VRI (Vulnerability and Resiliency Index) scores which are a measure of six socioeconomic indicators across counties in the United States. Better VRI scores were associated with better health outcomes (lower heart disease, cancer, and stroke death rates) across the rural-urban continuum. These analyses provide evidence to support the development of programs and policies that foster educational development, and economic diversity and vitality, as means of public health improvement, especially in rural areas in selected regions of the country. Rural-Urban Differences in the Public Health Workforce: Findings From Local Health Departments in three Rural Western States Date: 07 / 2002 Author(s): Rosenblatt RA, Casey S, Richardson M Research center: WWAMI Rural Health Research Center Topics: Public health, Workforce Citation: American Journal of Public Health, 92(7):1102-1105 Most local health departments or districts are small and rural; two thirds of the nation's 2832 local health departments serve populations smaller than 50,000 people. Rural local health departments have small staffs and slender budgets, yet they are expected to provide a wide array of services during a period when the health care system of which they are a part is undergoing change. This study provided quantitative, population-based data on the supply and composition of the rural public health workforce in 3 extremely rural states: Alaska, Montana, and Wyoming. The study focused on the relative supply of personnel in the principal public health occupational categories, differences across states in staffing levels, and difficulties experienced in recruiting and retaining personnel. Toxics Release Inventory Discharges and Population Health Outcomes in Rural and Urban Areas of the United States (Final Report) Author(s): Michael Hendryx, Evan Fedorko, Juhua Luo Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health The current study examines whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program were associated with population mortality rates and birth outcomes for both rural and urban populations. We also examined whether rural and urban areas characterized by poor socioeconomic status or higher percentages of racial minorities had greater TRI releases. Health outcomes included age-adjusted CDC mortality rates for cancer, respiratory, cardiovascular, and total causes, and NCHS birth outcomes including low birth weight, preterm births and birth defects. Rural counties are defined as non-metropolitan based on rural-urban continuum codes. The results show significantly higher adjusted total mortality rates associated with greater air and water releases in both rural and urban counties, after controlling for the effects of other risk variables. Effects were found in rural areas for total, cardiovascular, and (marginally) cancer mortality outcomes. We found that counties with higher percentages of African American populations had more non-zero releases, but did not find this for populations characterized by greater Native American populations, lower income levels or higher poverty. We did not find consistent evidence for higher TRI releases being related to poorer birth outcomes. Suggestions for reducing emissions, further research to understand human health impacts, and improving rural health care are presented. Toxics Release Inventory Discharges and Population Health Outcomes in Rural and Urban Areas of the United States (Policy Brief) Author(s): Michael Hendryx, Evan Fedorko, Juhua Luo Research center: West Virginia Rural Health Research Center Topics: Environmental & agricultural health, Public health Examined whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program were associated with population mortality rates for both rural and urban populations. Water Fluoridation and Dental Health Indicators in Rural and Urban Areas of the United States Date: 11 / 2011 Author(s): Michael Hendryx, Constance Weiner, Matthew Gurka Research center: West Virginia Rural Health Research Center Topics: Dental health, Environmental & agricultural health, Public health This study investigated the availability of fluoridated water across urban-rural settings, and relates measures of fluoride availability to national survey measures of dental health in adults and children.