In popular culture, rural America conjures images of picturesque landscapes, tranquility, and hale and hearty inhabitants. This fabled portrait of rural life, however, masks the depths of hardships and health disparities that many rural residents face. The rural public health landscape, for example, is far from idyllic; relative to urban and suburban regions, health care in rural areas is disproportionately afflicted with insufficient resources, limited access to care, fragmented service delivery, and significant provider shortages. Rural residents experience higher rates of chronic illness and certain types of cancer and are less likely to have health insurance than urban dwellers.

As these disparities have gained national attention in the past two decades, researchers have identified three interdependent forces that have shaped the current state of rural health ...

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