Effect of Federal Programs on Rural America


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Achieving Rural Health Equity and Well-Being


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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.




Health care in rural America


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Rural Poverty in the United States


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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.




Economic Restructuring and Family Well-being in Rural America


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"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.




Rebuilding the Unity of Health and the Environment in Rural America


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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.




Challenges for Rural America in the Twenty-First Century


Book Description

The twentieth century was one of profound transformation in rural America. Demographic shifts and economic restructuring have conspired to alter dramatically the lives of rural people and their communities. Challenges for Rural America in the Twenty-First Century defines these changes and interprets their implications for the future of rural America. The volume follows in the tradition of "decennial volumes" co-edited by presidents of the Rural Sociological Society and published in the Society's Rural Studies Series. Essays have been specially commissioned to examine key aspects of public policy relevant to rural America in the new century. Contributors include:Lionel Beaulieu, Alessandro Bonnano, David Brown, Ralph Brown, Frederick Buttel, Ted Bradshaw, Douglas Constance, Steve Daniels, Lynn England, William Falk, Cornelia Flora, Jan Flora, Glenn Fuguitt, Nina Glasgow, Leland Glenna, Angela Gonzales, Gary Green, Rosalind Harris, Tom Hirschl, Douglas Jackson-Smith, Leif Jensen, Ken Johnson, Richard Krannich, Daniel Lichter, Linda Lobao, Al Luloff, Tom Lyson, Kate MacTavish, David McGranahan, Diane McLaughlin, Philip McMichael, Lois Wright Morton, Domenico Parisi, Peggy Petrzelka, Kenneth Pigg, Rogelio Saenz, Sonya Salamon, Jeff Sharp, Curtis Stofferahn, Louis Swanson, Ann Tickameyer, Leanne Tigges, Cruz Torres, Mildred Warner, Ronald Wimberley, Dreamal Worthen, and Julie Zimmerman.




Government's Greatest Achievements


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In an era of promises to create smaller, more limited government, Americans often forget that the federal government has amassed an extraordinary record of successes over the past half century. Despite seemingly insurmountable odds, it helped rebuild Europe after World War II, conquered polio and other life-threatening diseases, faced down communism, attacked racial discrimination, reduced poverty among the elderly, and put men on the moon. In Government's Greatest Achievements, Paul C. Light explores the federal government's most successful accomplishments over the previous five decades and anticipates the most significant challenges of the next half century. While some successes have come through major legislation such as the 1965 Medicare Act, or large-scale efforts like the Apollo space program, most have been achieved through collections of smaller, often unheralded statutes. Drawing on survey responses from 230 historians and 220 political scientists at colleges and universities nationwide, Light ranks and summarizes the fifty greatest government achievements from 1944 to 1999. The achievements were ranked based on difficulty, importance, and degree of success. Through a series of twenty vignettes, he paints a vivid picture of the most intense government efforts to improve the quality of life both at home and abroad—from enhancing health care and workplace safety, to expanding home ownership, to improving education, to protecting endangered species, to strengthening the national defense. The book also examines how Americans perceive government's greatest achievements, and reveals what they consider to be its most significant failures. America is now calling on the government to resolve another complex, difficult problem: the defeat of terrorism. Light concludes by discussing this enormous task, as well as government's other greatest priorities for the next fifty years.




Federalism and Health Policy


Book Description

The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.