Problems of access to health care facing Appalachia mountain communities are confounded by unemployment, poverty, low education, and local religious beliefs that barrier people from receiving medical care. This proceedings addresses the issues related to health access and health needs. It contains 20 papers and 12 synopses of presentation. The…

Rural health care can thrive if innovative tactics are used. Four principles can influence health care services: (1) an integrative approach is needed; (2) recognition that competition is a dominant mode; (3) cultural and professional ethnocentricity are counterproductive; and (4) the possibilities are limitless. (Author/MSE)

Key factors of a model for training community health aides are (1) extended time for updating and reinforcing skills; (2) relevance to local situations; (3) group process and interpersonal communication training; (4) practical materials; and (5) participation of physicians, local health workers, and community leaders in rural health policy…

Twenty-nine Alabama optometric practices were studied using an optometrist survey, one-week patient flow analysis, and audit of patient records. Results indicate some special facets of the rural practices that may require a different kind of educational preparation. (MSE)

Seven common myths about rural America are debunked, and three characteristics of the rural environment (diversity, sparse population, and interdependency with broader social and economic forces) are examined in relation to health care delivery and medical education. Health care contributions to rural economic needs are discussed. (Author/MSE)

Wayne Myers, director of the Office of Rural Health Policy, discusses Appalachian rural health and access to health care. The health manpower shortage in Central Appalachia still exists but is less severe than 10 years ago. The needs of underserved areas could be address by training local people in the community and through telemedicine and…

Medical students that come from rural areas are more likely to return to rural areas to practice, but rural students apply for medical school at half the rate of urban students. Factors that contribute to this problem are the lack of rural representation on medical school selection committees; centralization of medical education facilities in…

Medical schools have increasingly ignored underserved communities' needs. Descriptions of five demonstration programs show how community-driven approaches to medical education involve academic and rural communities, select students from underserved areas, and train learners in undeserved communities. The approach also supports underserved…

In March 1989 this working group explored how the federal government might better address rural America's problems. The WGRD consisted of key officials from relevant federal departments and agencies, who came together to explore the following areas of rural development programming: (1) rural education and training; (2) rural economic development;…

A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

Economic pressures along with health, nutrition, housing, sanitation, and child labor problems contribute in large measure to the plight of the migrant population. The incomplete and fragmented education migrant children receive is further compounded by low expectations from teachers and inappropriate curriculums. Legislative action has attempted…

Many recent changes affecting the general and rural health care system are reviewed. The American Association of Medical Colleges' recommends a task force on rural health and medical education be established to begin active dialogue on how medical education can effectively respond to the challenges of rural health. (Author/MSE)

Addressing the lack of cooperation between early intervention programs and the rural health community, this monograph presents eight papers by educators and health professionals who identify specific problems and offer solutions in the form of effective collaboration techniques and model programs. Papers by Susan Hastings and Stewart Gabel…

This paper explores the broad definition of health in the rural context and relates it to policy, practice, and pedagogical challenges in providing access to services in rural areas. Historically, policy, practice, and teaching institutions have supported a dependency model for health service delivery, forcing rural communities to rely on…

Federal block grants and consolidated programs related to poverty reduction may compel states to streamline administrative structures and approaches that have deterred collaboration in the past. This report considers the block grant environment in making key policy recommendations for reducing poverty in rural areas, formulated during a Pathways…