Quality Through Collaboration The Future of Rural Health (2005) / Chapter Skim
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Appendix B Characteristics of Rural Populations
Appendix B Characteristics of Rural Populations
Pages 200-219
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From page 200... ...
Degree of rurality versus urbanization is defined on a continuum. DEFINING RURAL AMERICA In general, a rural area is considered a place of low population density.
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OMB expands the Census Bureau's definition to a county-based approach to measure the extent to which a large city's (central city) economic influence extends beyond its limits.
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Micropolitan CBSAs exceeding 1,000 per square mile. must have at least one urban Urban clusters include free- cluster of 10,00049,999.
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Nonmetropolitan counties micropolitan counties adjacent to large Nonmetropolitan counties metro areas, urban population of 20,000+, adjacent to noncore counties adjacent to large metro metro area, areas, urban population of 20,000+, not adjacent micropolitan counties adjacent to small to metro area, metro areas, urban population of 2,50019,999, noncore counties adjacent to small metro adjacent to metro area, areas, urban population of 2,50019,999, not noncore counties adjacent to small metro adjacent to metro area, areas with own town, completely rural or less than 2,500 urban micropolitan counties not adjacent to a population, adjacent to metro area, and metro area, completely rural or less than 2,500, not noncore counties adjacent to a adjacent to metro area. micropolitan area with own town, Definitions applied in year 2003.
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"Frontier areas," a term used mainly by rural health and agriculture officials, are considered the most thinly settled counties, with population densities of fewer than seven households per square mile. Figure B-2 provides an overview of frontier areas.
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Although the ruralurban continuum codes and urban influence codes do not include parameters for frontier areas, the USDA ERS uses the following definition for measurements: frontier areas = 7 households per square mile. Frontier population = 2.9 million,c 1.0 percent of total population.
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206 classifications. code continuum urban Rural Service: Research Alaska Economic USDA 2003a.
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(433 (2,667 mile more or areas. square mile per frontier people square and 7 per rural, than people Less 7 Metropolitan, Service: Alaska Research 2004.
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. The growth rate of the older rural population is expected to be quite high over the next 20 years as the baby boomers move into retirement age.4 This increasing age trend has significant implications for health care needs.
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= (153 (464 migration migration migration net net net high high low ,2000; percent, percent, older or elderly elderly 60 High High aged Americans. older population the Alaska Rural of 2000.
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Figure B-4 provides an overview of the population growth rates by race and ethnicity in metropolitan and rural areas from 1990 to 2000. For the 2000 census, 10.2 million rural residents identified themselves as belonging to racial or ethnic groups -- a 30 percent increase over the last decade (Census, 2003b)
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Counties in the first two regions contain reservations on which Native Americans are exercising greater economic and political control; however, poverty and unemployment remain high. For Alaska Natives, low population density and isolation from major population centers severely limit economic development prospects and increase health care delivery costs.
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.6 For the same period, the poverty rate grew by 20 percent over that in the 1990s in 444 nonmetropolitan counties7 (e.g., the poverty rate is annual income <$16,895 for a family of two adults and two minor children) .8 In 2000, a total of 494 counties had poverty levels of 6Weekly earnings for nonmetropolitan residents who had completed high school (but no further training)
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Methods must be found to assist small and medium-sized employers in obtaining affordable health insurance. In addition, employers need to become more engaged in providing their employees with resources for health/ wellness education and disease management programs, perhaps through partnerships with other local community organizations to share resources.
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About 41 percent of rural residents have completed 1 or more years of schooling beyond high school, indicating an initial interest in and motivation for higher education. Demographic and geographic characteristics10 strongly influence college attainment in rural areas, while the status of the local economy affects whether those with a college degree remain in the community given the smaller proportion of jobs that require advanced education.11 Rural communities need to fully leverage the availability of local colleges and universities by enhancing their role in bridging the gaps in educational opportuni 10 Rural non-Hispanic whites are twice as likely to have a college degree as other rural groups, while rural Hispanics have the lowest attainment (about half have not finished high school, and only 1 in 16 has completed 4 years of college)
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For example, a community college could offer associate degrees in nursing and computer science, and the two departments could develop a partnership to establish an education and support center for local providers implementing health information and communications applications, and for local residents who would like to learn how to use self-care monitoring devices and/or participate in online disease management programs. Local colleges could also partner with local community libraries to provide residents with a resource for general adult literacy programs, health literacy programs (e.g., locating and understanding health information)
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. The lower penetration rates coincide with the demographic patterns of rural areas -- lower-income people, older people, and minorities exhibit lower rates of Internet usage.13 Internet users in rural areas keep pace with those in other areas: 45 percent of rural Internet users access the Internet daily, versus 40 percent for urban and 46 percent for 13 Senior citizens make up a larger proportion of rural residents but are less likely to go online -- only 17 percent of rural seniors use the Internet.
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It is imperative that rural communities develop these resources for their populations -- perhaps in the form of community telecenters that might be associated with public libraries and local colleges. Understanding and being able to use the Internet for health communications and information retrieval will have a significant impact on access to and the quality of health care services for rural residents, and more important, is necessary for self-care and disease management in the knowledgebased economy.
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2002. Rural healthy people 2010: Identifying rural health priorities and models for practice.
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From page 219... ...
Portland, ME: Maine Rural Health Research Center, University of Southern Maine.
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