Local Governments and Rural Development


Book Description

Despite the recent economic upswing in many Latin American countries, rural poverty rates in the region have actually increased during the past two decades. Experts blame excessively centralized public administrations for the lackluster performance of public policy initiatives. In response, decentralization reformshave become a common government strategy for improving public sector performance in rural areas. The effect of these reforms is a topic of considerable debate among government officials, policy scholars, and citizensÕ groups. This book offers a systematic analysis of how local governments and farmer groups in Latin America are actually faring today. Based on interviews with more than 1,200 mayors, local officials, and farmers in 390 municipal territories in four Latin American nations, the authors analyze the ways in which different forms of decentralization affect the governance arrangements for rural development Òon the ground.Ó Their comparative analysis suggests that rural development outcomes are systemically linked to locally negotiated institutional arrangementsÑformal and informalÑbetween government officials, NGOs, and farmer groups that operate in the local sphere. They find that local-government actors contribute to public services that better assist the rural poor when local actors cooperate to develop their own institutional arrangements for participatory planning, horizontal learning, and the joint production of services. This study brings substantive data and empirical analysis to a discussion that has, until now, more often depended on qualitative research in isolated cases. With more than 60 percent of Latin AmericaÕs rural population living in poverty, the results are both timely and crucial.




Rationalizing Rural Area Classifications for the Economic Research Service


Book Description

The U.S. Department of Agriculture Economic Research Service (USDA/ERS) maintains four highly related but distinct geographic classification systems to designate areas by the degree to which they are rural. The original urban-rural code scheme was developed by the ERS in the 1970s. Rural America today is very different from the rural America of 1970 described in the first rural classification report. At that time migration to cities and poverty among the people left behind was a central concern. The more rural a residence, the more likely a person was to live in poverty, and this relationship held true regardless of age or race. Since the 1970s the interstate highway system was completed and broadband was developed. Services have become more consolidated into larger centers. Some of the traditional rural industries, farming and mining, have prospered, and there has been rural amenity-based in-migration. Many major structural and economic changes have occurred during this period. These factors have resulted in a quite different rural economy and society since 1970. In April 2015, the Committee on National Statistics convened a workshop to explore the data, estimation, and policy issues for rationalizing the multiple classifications of rural areas currently in use by the Economic Research Service (ERS). Participants aimed to help ERS make decisions regarding the generation of a county rural-urban scale for public use, taking into consideration the changed social and economic environment. This report summarizes the presentations and discussions from the workshop.




Achieving Rural Health Equity and Well-Being


Book Description

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.




Rural Public Health


Book Description

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Homelessness, Health, and Human Needs


Book Description

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.




Rebuilding the Unity of Health and the Environment in Rural America


Book Description

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.







Foundations of Rural Public Health in America


Book Description

Foundations of Rural Public Health in America spans a wide variety of important issues affecting rural public health, including consumer and family health, environmental and occupational health, mental health, substance abuse, disease prevention and control, rural health care delivery systems, and health disparities. Divided into five sections, the book covers understanding rural communities, public health systems and policies for rural communities, health disparities in rural communities and among special populations, and advancing rural health including assessment, planning and intervention. Written by a multidisciplinary team of experienced scholars and practitioners, this authoritative text comprehensively covers rural health issues today.




Quality Through Collaboration


Book Description

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.




Rural Poverty in the United States


Book Description

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.