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 healthcare
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