Journal article
Kelsey M. Owsley, Mika Hamer, Glen P. Mays
American Journal of Public Health, vol. 110(S2), 2020, pp. S204-S210
American Journal of Public Health, vol. 110(S2), 2020, pp. S204-S210
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APA
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Owsley, K. M., Hamer, M., & Mays, G. P. (2020). The Growing Divide in Public Health Delivery Systems in US Rural and Urban Communities. American Journal of Public Health, 110(S2), S204–S210.
Chicago/Turabian
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Owsley, Kelsey M., Mika Hamer, and Glen P. Mays. “The Growing Divide in Public Health Delivery Systems in US Rural and Urban Communities.” American Journal of Public Health 110, no. S2 (2020): S204–S210.
MLA
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Owsley, Kelsey M., et al. “The Growing Divide in Public Health Delivery Systems in US Rural and Urban Communities.” American Journal of Public Health, vol. 110, no. S2, 2020, pp. S204–S210.
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@article{kelsey2020a,
title = {The Growing Divide in Public Health Delivery Systems in US Rural and Urban Communities},
year = {2020},
issue = {S2},
journal = {American Journal of Public Health},
pages = {S204-S210},
volume = {110},
author = {Owsley, Kelsey M. and Hamer, Mika and Mays, Glen P.}
}
Objectives. To examine changes in the scope of activity and organizational composition
of public health delivery systems serving rural and urban US communities between
2014 and 2018.
Methods. We used data from the National Longitudinal Survey of Public Health
Systems to measure the implementation of recommended public health activities and
the network of organizations contributing to these activities in a nationally representative
cohort of US communities. We used multivariable regression models to test for
rural–urban differences between 2014 and 2018.
Results. The scope of recommended activities implemented in rural areas declined by
3.4 percentage points between 2014 and 2018, whereas it increased by 1.4 percentage
points in urban areas.The rural–urban disparity in scope of activities grew by a total of 4.8
percentage points (P < .05) over this time. The disparity in network density grew by 2.3
percentage points (P < .05).
Conclusions. Urban public health systems have enhanced their scope of activities and
organizational networks since 2014, whereas rural systems have lost capacity. These
trends suggest that system improvement initiatives have had uneven success, and they
may contribute to growing rural–urban disparities in population health status.
of public health delivery systems serving rural and urban US communities between
2014 and 2018.
Methods. We used data from the National Longitudinal Survey of Public Health
Systems to measure the implementation of recommended public health activities and
the network of organizations contributing to these activities in a nationally representative
cohort of US communities. We used multivariable regression models to test for
rural–urban differences between 2014 and 2018.
Results. The scope of recommended activities implemented in rural areas declined by
3.4 percentage points between 2014 and 2018, whereas it increased by 1.4 percentage
points in urban areas.The rural–urban disparity in scope of activities grew by a total of 4.8
percentage points (P < .05) over this time. The disparity in network density grew by 2.3
percentage points (P < .05).
Conclusions. Urban public health systems have enhanced their scope of activities and
organizational networks since 2014, whereas rural systems have lost capacity. These
trends suggest that system improvement initiatives have had uneven success, and they
may contribute to growing rural–urban disparities in population health status.
