Hartley David
MHA, Muskie School of Public Service, University of Southern Maine, PO Box 9300, 509 Forest Ave, Portland, ME 04104, USA.
Am J Public Health. 2004 Oct;94(10):1675-8. doi: 10.2105/ajph.94.10.1675.
In this commentary, I place the maturing field of rural health research and policy in the context of the rural health disparities documented in Health United States, 2001, Urban and Rural Health Chartbook. Because of recent advances in our understanding of the determinants of health, the field must branch out from its traditional focus on access to health care services toward initiatives that are based on models of population health. In addition to presenting distinct regional differences, the chartbook shows a pattern of risky health behaviors among rural populations that suggest a "rural culture" health determinant. This pattern suggests that there may be environmental and cultural factors unique to towns, regions, or United States Department of Agriculture (USDA) economic types that affect health behavior and health.
在这篇评论中,我将农村卫生研究与政策这一不断成熟的领域置于《2001年美国卫生状况:城乡卫生图表手册》中所记录的农村卫生差距背景下进行探讨。鉴于我们对健康决定因素的理解最近取得了进展,该领域必须从其传统上对获得医疗服务的关注拓展至基于人群健康模式的举措。除了呈现出明显的地区差异外,该图表手册还展示了农村人口中存在的一系列危险健康行为模式,这暗示了一种“农村文化”健康决定因素。这种模式表明,城镇、地区或美国农业部(USDA)经济类型可能存在独特的环境和文化因素,这些因素会影响健康行为和健康状况。