Rural Health Care Systems

Vernon E. Wilson, MD
JAMA. 1971;216(10):1623-1626. doi:10.1001/jama.1971.03180360069010.
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Rural health is a problem of two basic dimensions. These are financial status and geographic location.

As to financial status, rural areas are characterized by below-average incomes and considerable poverty. The great majority of the poorest counties in the United States are rural.

As to geographic location, rural areas generally have a cluster of factors that are adverse to adequate health services. Along with population densities that range from low to sparse, rural areas usually have a limited tax base, scarce and widely dispersed health facilities, extreme shortages of health manpower, and negative attraction for new manpower.

And yet, despite this somewhat grim summary, I think that the outlook for rural health is more encouraging than at any previous time.

The most encouraging development on the income dimension is a growing realization that abject poverty is a national disgrace. No country as affluent as the United States can knowingly tolerate


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