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Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop.
"A compilation of policy-relevant research by a multidisciplinary group of scholars on the state of families in rural America in the twenty-first century. Examines the impact of economic restructuring on rural Americans and provides policy recommendations for addressing the challenges they face"--Provided by publisher.
America's rural areas have always held a disproportionate share of the nation's poorest populations. Rural Poverty in the United States examines why. What is it about the geography, demography, and history of rural communities that keeps them poor? In a comprehensive analysis that extends from the Civil War to the present, Rural Poverty in the United States looks at access to human and social capital; food security; healthcare and the environment; homelessness; gender roles and relations; racial inequalities; and immigration trends to isolate the underlying causes of persistent rural poverty. Contributors to this volume incorporate approaches from multiple disciplines, including sociology, economics, demography, race and gender studies, public health, education, criminal justice, social welfare, and other social science fields. They take a hard look at current and past programs to alleviate rural poverty and use their failures to suggest alternatives that could improve the well-being of rural Americans for years to come. These essays work hard to define rural poverty's specific metrics and markers, a critical step for building better policy and practice. Considering gender, race, and immigration, the book appreciates the overlooked structural and institutional dimensions of ongoing rural poverty and its larger social consequences.
Throughout much of its history, the United States was predominantly a rural society. The need to provide sustenance resulted in many people settling in areas where food could be raised for their families. Over the past century, however, a quiet shift from a rural to an urban society occurred, such that by 1920, for the first time, more members of our society lived in urban regions than in rural ones. This was made possible by changing agricultural practices. No longer must individuals raise their own food, and the number of person-hours and acreage required to produce food has steadily been decreasing because of technological advances, according to Roundtable member James Merchant of the University of Iowa. The Institute of Medicine's Roundtable on Environmental Health Science, Research, and Medicine held a regional workshop at the University of Iowa on November 29 and 30, 2004, to look at rural environmental health issues. Iowa, with its expanse of rural land area, growing agribusiness, aging population, and increasing immigrant population, provided an opportunity to explore environmental health in a region of the country that is not as densely populated. As many workshop participants agreed, the shifting agricultural practices as the country progresses from family operations to large-scale corporate farms will have impacts on environmental health. This report describes and summarizes the participants' presentations to the Roundtable members and the discussions that the members had with the presenters and participants at the workshop.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.