Achieving
Rural Health Equity
and Well-Being
PROCEEDINGS OF A WORKSHOP
Steve Olson and Karen M. Anderson, Rapporteurs
Roundtable on Population Health Improvement
Roundtable on the Promotion of Health Equity
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by contracts between the National Academy of Sciences and Aetna Foundation (15-1381); The California Endowment (20171618); General Electric; Health Resources and Services Administration (HHSH25034007T); Kaiser Permanente; The Kresge Foundation (R-1512-255471); New York State Health Foundation (15-03733); Robert Wood Johnson Foundation (73263); and U.S. Department of Health and Human Services (HHSP23337054). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-46905-0
International Standard Book Number-10: 0-309-46905-8
Digital Object Identifier: https://doi.org/10.17226/24967
Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2018 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Achieving rural health equity and well-being: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24967.
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PLANNING COMMITTEE ON ACHIEVING RURAL HEALTH EQUITY AND WELL-BEING1
JULIE A. BALDWIN, Center for Health Equity Research, Northern Arizona University
MARTHE GOLD, The New York Academy of Medicine
JEFFREY A. HENDERSON, Black Hills Center for American Indian Health
DENNIS JOHNSON, Children’s Health Fund
OCTAVIO N. MARTINEZ, Hogg Foundation for Mental Health, The University of Texas at Austin
PHYLLIS D. MEADOWS, The Kresge Foundation
ALAN MORGAN, National Rural Health Association
TIM SIZE, Rural Wisconsin Health Cooperative
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE J. ISHAM (Co-Chair), HealthPartners
SANNE MAGNAN (Co-Chair), University of Minnesota
PHILIP M. ALBERTI, Association of American Medical Colleges
TERRY ALLAN, Cuyahoga County Board of Health
JOHN AUERBACH, Trust for America’s Health
CATHY BAASE, The Dow Chemical Company, Michigan Health Improvement Alliance
DEBBIE I. CHANG, Nemours
CHARLES J. FAZIO, HealthPartners
GEORGE R. FLORES, The California Endowment
KATHY GERWIG, Health and Wellness and Environmental Stewardship Officer, Kaiser Permanente
ALAN GILBERT, GE Healthymagination
MARY LOU GOEKE, United Way of Santa Cruz County
MARTHE GOLD, The New York Academy of Medicine
MARC N. GOUREVITCH, New York University Langone School of Medicine
GARTH GRAHAM, Aetna Foundation
GARY R. GUNDERSON, Wake Forest University
WAYNE JONAS, H&S Ventures
ROBERT M. KAPLAN, Stanford University
DAVID A. KINDIG, University of Wisconsin–Madison
PAULA M. LANTZ, University of Michigan
MICHELLE LARKIN, Robert Wood Johnson Foundation
THOMAS A. LAVEIST, The George Washington University
JEFFREY LEVI, The George Washington University
SARAH R. LINDE, Health Resources and Services Administration
SHARRIE MCINTOSH, New York State Health Foundation
PHYLLIS D. MEADOWS, The Kresge Foundation
BOBBY MILSTEIN, Rethink Health
JOSÉ T. MONTERO, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention
MARY PITTMAN, Public Health Institute
PAMELA RUSSO, Robert Wood Johnson Foundation
JAMES N. WEINSTEIN, Dartmouth-Hitchcock
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
Roundtable on Population Health Improvement Staff
ALINA BACIU, Director, Roundtable on Population Health Improvement
DARLA THOMPSON, Program Officer (through August 2017)
KIMANI HAMILTON-WRAY, Senior Program Assistant (from April 2017)
HOPE HARE, Administrative Assistant
ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice
ROUNDTABLE ON THE PROMOTION OF HEALTH EQUITY1
ANTONIA VILLARRUEL (Chair), University of Pennsylvania
PATRICIA BAKER, Connecticut Health Foundation
JULIE A. BALDWIN, Center for Health Equity Research, Northern Arizona University
GILLIAN BARCLAY, Nevada Governor’s Office of Economic Development
NED CALONGE, The Colorado Trust
KENDALL M. CAMPBELL, Brody School of Medicine, East Carolina University
LUTHER T. CLARK, Merck & Co., Inc.
FRANCISCO GARCÍA, Pima County Department of Health
JEFFREY A. HENDERSON, Black Hills Center for American Indian Health
EVE J. HIGGINBOTHAM, University of Pennsylvania
CARA V. JAMES, Centers for Medicare & Medicaid Services
CHRIS KABEL, The Kresge Foundation
MELENIE MAGNOTTA, Aetna Foundation
OCTAVIO N. MARTINEZ, Hogg Foundation for Mental Health, The University of Texas at Austin
CHRISTINE RAMEY, Health Resources and Services Administration
MELISSA A. SIMON, Northwestern University Feinberg School of Medicine
PATTIE TUCKER, Centers for Disease Control and Prevention
UCHENNA S. UCHENDU, Office of Health Equity, U.S. Department of Veterans Affairs
ROHIT VARMA, University of Southern California
WINSTON WONG, Kaiser Permanente
Roundtable on the Promotion of Health Equity Staff
KAREN ANDERSON, Director, Roundtable on the Promotion of Health Equity
ANNA MARTIN, Senior Program Assistant
HOPE HARE, Administrative Assistant
ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
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Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
CATHERINE BRYAN, First Nations Development Institute
ALAN MORGAN, National Rural Health Association
WALTER NILES, Office of Minority Health and Health Equity
GLENDA SMITH, University of Alabama
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by DEBORAH POWELL, University of Minnesota. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.
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Contents
Organization and Themes of the Workshop
2 POTENTIAL CHALLENGES AND OPPORTUNITIES IN RURAL COMMUNITIES
3 LEVERAGING RESOURCES TO ADVANCE EQUITY IN RURAL AREAS
The Black Belt Community Foundation
The Appalachian Community Fund
The Con Alma Health Foundation
4 BUILDING GREATER PROSPERITY IN RURAL COMMUNITIES
Providing Hope in the Mid-South States
Resiliency and Opportunity: Farmworkers in Florida