Abstract:
:Objectives. To investigate differences in funding and service delivery between rural and urban local health departments (LHDs) in the United States.Methods. In this repeated cross-sectional study, we examined rural-urban differences in funding and service provision among LHDs over time using 2010 and 2016 National Association of County and City Health Officials data.Results. Local revenue among urban LHDs (41.2%) was higher than that in large rural (31.3%) and small rural LHDs (31.2%; P < .05). Small (20.9%) and large rural LHDs (19.8%) reported greater reliance on revenue from Center for Medicare and Medicaid Services than urban LHDs (11.5%; P < .05). All experienced decreases in clinical revenue between 2010 and 2016. Urban LHDs provided less primary care services in 2016; rural LHDs provided more mental health and substance abuse services (P < .05).Conclusions. Urban LHDs generated more revenues from local sources, and rural LHDs generated more from the Center for Medicare and Medicaid Services and clinical services. Rural LHDs tended to provide more clinical services. Given rural LHDs' reliance on clinical revenue, decreases in clinical services could have disproportionate effects on them.Public Health Implications. Differences in financing and service delivery by rurality have an impact on the communities. Rural LHDs rely more heavily on state and federal dollars, which are vulnerable to changes in state and national health policy.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Beatty K,Heffernan M,Hale N,Meit Mdoi
10.2105/AJPH.2020.305757subject
Has Abstractpub_date
2020-09-01 00:00:00pages
1293-1299issue
9eissn
0090-0036issn
1541-0048journal_volume
110pub_type
杂志文章abstract::This study is the first to provide complete information on prevalence rates by gender and geographic variation for each type of tobacco product used in the United States. Results indicate that, in nearly half of all states, total tobacco use in men exceeded 40% and, in four states, exceeded 50%. In women, only Nevada,...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.82.1.103
更新日期:1992-01-01 00:00:00
abstract::A two-week composite sample of prime time television programming from fall 1984 was analyzed for portrayals of alcohol and tobacco. Earlier studies note that smoking acts have progressively declined, suggesting smoking is no longer as frequent on prime time television. The current study notes higher levels of smoking....
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.76.6.698
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVES:We identified courses of depressive symptoms in an epidemiological sample of emerging adults. METHODS:We used latent class growth modeling to identify trajectories of depressive symptoms measured by the 12-item Center for Epidemiological Studies Depression Scale (CES-D) during a 14-year follow-up of 2825 Ca...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2015.302817
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:Message tailoring, based on individual needs and circumstances, is commonly used to enhance face-to-face patient counseling. Only recently has individual tailoring become feasible for printed messages. This study sought to determine whether printed tailored recommendations addressing women's specific screeni...
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.84.1.43
更新日期:1994-01-01 00:00:00
abstract::As one element of Baltimore's effort to combat its high rate of teenage pregnancy, the Baltimore City Health Department added the implantable contraceptive Norplant to the array of services offered at one of its school-based health centers in early 1993. The initial findings with the adolescents who received this cont...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.85.3.309
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:This study evaluated a nurse-managed smoking cessation program for smokers hospitalized for a variety of conditions. METHODS:Hospitalized patients who smoked prior to hospitalization and who were motivated to quit (n = 660) were randomized to intervention or usual-care groups and followed for the next year....
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.86.11.1557
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVES:We investigated how state-level firearms legislation is associated with firearm ownership and storage among families with preschool-aged children. METHODS:Using 2005 nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (n = 8100), we conducted multinomial regression models...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.301928
更新日期:2014-06-01 00:00:00
abstract::Suicide is a public health problem disproportionately associated with some demographic characteristics (e.g., sexual orientation, veteran status). Analyses of the Massachusetts Behavioral Risk Factor Surveillance Survey data revealed that more lesbian, gay, and bisexual (i.e., sexual minority) veterans reported suicid...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300565
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis. METHODS:We examined VHA electronic medical records from 2000 through 2011 for 2 o...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301507
更新日期:2013-10-01 00:00:00
abstract::Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic co...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.75.7.749
更新日期:1985-07-01 00:00:00
abstract::We studied sexual orientation disparities in health outcomes among US adolescents by pooling multiple Youth Risk Behavior Survey (YRBS) data sets from 2005 and 2007 for 14 jurisdictions. Here we describe the methodology for pooling and analyzing these data sets. Sexual orientation-related items assessed sexual orienta...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301748
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:We compared cycling injury risks of 14 route types and other route infrastructure features. METHODS:We recruited 690 city residents injured while cycling in Toronto or Vancouver, Canada. A case-crossover design compared route infrastructure at each injury site to that of a randomly selected control site fro...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2012.300762
更新日期:2012-12-01 00:00:00
abstract::Affirmative action programs of all types are under attack legally and politically. Although medical schools have not been specifically targeted, their affirmative action programs, like others in higher education, are potentially in danger. This article examines the current legal status of affirmative action in medical...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.89.8.1256
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVES:This analysis describes trends in the prevalence of genital chlamydial infection in economically disadvantaged young women entering a national job training program. METHODS:We examined chlamydia test data for May 1990 through June 1997 for women aged 16 to 24 years who enrolled in the program. The significa...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.91.8.1287
更新日期:2001-08-01 00:00:00
abstract::Dynamic treatment regimes are an emerging and important methodological area in health research, particularly in the management of chronic health conditions. This paradigm encompasses the ideological shift in research from the acute care model to the chronic care model. It allows individualization of treatment (type, d...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2010.198937
更新日期:2011-01-01 00:00:00
abstract::This paper offers suggestions to adi the selection of appropriate instruments and data gathering methods for studies that require measures of personal health status applicable in general populations. Before selecting measures, the reason for studying health status must be identified. Next, definitional issues arise wh...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.71.6.620
更新日期:1981-06-01 00:00:00
abstract::Homeless children in New York City had an extremely high asthma prevalence-40%-in a cross-sectional study at 3 shelters (n=740) during 1998 to 1999. We used the same protocol to summarize subsequent data through December 2002. Asthma prevalence was 33% (n=1636); only 15% of the children previously diagnosed were takin...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.070482
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:This study reports on Canadian mammography rates between 1990, when mass screening programs were launched, and 1994/95. METHODS:Mammography rates from 2 national surveys were compared according to the presence of a provincial screening program. RESULTS:Mammography rates among women aged 50 to 69 years (the...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.89.6.927
更新日期:1999-06-01 00:00:00
abstract::Objectives. To report trends in sexual violence (SV) emergency department (ED) visits in the United States.Methods. We analyzed monthly changes in SV rates (per 100 000 ED visits) from January 2017 to December 2019 using Centers for Disease Control and Prevention's National Syndromic Surveillance Program data. We stra...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2020.306034
更新日期:2021-01-21 00:00:00
abstract:OBJECTIVES:How do health care professionals assess the care of hospital patients near the end of life? Are physicians and nurses aware of and in agreement with national recommendations regarding patients' rights to forgo life-sustaining medical treatments and to receive adequate pain control? METHODS:We surveyed 687 p...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.83.1.14
更新日期:1993-01-01 00:00:00
abstract::Falls and fall-induced injuries in older people are a major public health problem in modern societies with aging populations. Injury is the fifth leading cause of death in older adults, and most of these fatal injuries are related to falls. We have assessed the nationwide trends in fall-induced deaths of older people ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2004.047779
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to prospectively assess the independent effect of hip fracture on mortalìty, hospitalization, and functional status. METHODS:Among 7527 members of the Longitudinal Study of Aging who were over age 70 at baseline, 368 persons with hip fracture occurring between 1984 and 1991 wer...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.87.3.398
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVES:We assessed the effect of public health leadership training on the capacity of public health leaders to perform competencies derived from the list of "Ten Essential Public Health Services" presented in 1994 by the steering committee of the Public Health Functions Project. METHODS:Graduating scholars of the ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.94.7.1245
更新日期:2004-07-01 00:00:00
abstract::This paper uses claims data from a universal health care system to describe physicians' hospitalization styles after adjusting for case-mix characteristics of their primary patients. Patients were uniquely assigned to that physician (general or family practitioners, internist, general surgeon, or obstetrician/gynecolo...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.76.1.45
更新日期:1986-01-01 00:00:00
abstract::The authors review the available empirical evidence from population-based studies of the association between perceptions of racial/ethnic discrimination and health. This research indicates that discrimination is associated with multiple indicators of poorer physical and, especially, mental health status. However, the ...
journal_title:American journal of public health
pub_type: 杂志文章,评审
doi:10.2105/ajph.93.2.200
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVES:We analyzed smoking survey data across communities in Chicago, Ill, to explore community-level variations in smoking behavior. METHODS:We conducted a health survey of 6 racially and ethnically diverse Chicago communities during 2002-2003. The survey included questions about current smoking, smoking history,...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2004.051169
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:We estimated dementia incidence rates, life expectancies with and without dementia, and percentage of total life expectancy without dementia. METHODS:We studied 3605 members of Group Health (Seattle, WA) aged 65 years or older who did not have dementia at enrollment to the Adult Changes in Thought study bet...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2014.301935
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:We examined the pathways to smoking cessation between late adolescence and young adulthood. METHODS:We obtained data from a sample of urban African American and Puerto Rican young adults (N=242), mean age 19 years, who reported tobacco use and determined cessation rates between late adolescence and young ad...
journal_title:American journal of public health
pub_type: 杂志文章,多中心研究
doi:10.2105/AJPH.2006.101212
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:We determined whether and to what extent a woman's exposure to stressful life events prior to conception (PSLEs) was associated with preterm birth and whether maternal age modified this relationship. METHODS:We examined 9350 mothers and infants participating in the first wave of the Early Childhood Longitud...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301688
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:We used data from the National Health Interview Survey to compare health care access among individuals involved in same-sex versus opposite-sex relationships. METHODS:We conducted descriptive and logistic regression analyses from pooled data on 614 individuals in same-sex relationships and 93418 individuals...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.062661
更新日期:2006-06-01 00:00:00