Structural Urbanism Contributes To Poorer Health Outcomes For Rural America
Structural Urbanism Contributes To Poorer Health Outcomes For Rural America
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DOI：
10.1377/hlthaff.2019.00914
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发表时间：
2019-12-01
期刊：
影响因子：
9.7
通讯作者：
Crouch, Elizabeth
中科院分区：
文献类型：
--
作者：
Probst, Janice;Eberth, Jan Marie;Crouch, Elizabeth
农村人口不成比例地遭受不利的健康后果，包括健康状况较差和年龄调整死亡率较高。我们认为，这些差距部分是由于农村社区的医疗服务提供者的可用性和可及性下降。“结构性城市化”-当前公共卫生和保健系统中不利于农村社区的因素-加剧了农村的挑战。我们认为，当前医疗保健筹资模式的偏见，将医疗保健视为个人的服务，而不是人口的基础设施，天生偏向于大人口。在认识到这一偏见之前，就无法在整个城乡统一体中发展可行的护理模式。
Rural populations disproportionately suffer from adverse health outcomes, including poorer health and higher age-adjusted mortality. We argue that these disparities are due in part to declining health care provider availability and accessibility in rural communities. Rural challenges are exacerbated by "structural urbanism"-elements of the current public health and health care systems that disadvantage rural communities. We suggest that biases in current models of health care funding, which treat health care as a service for an individual rather than as infrastructure for a population, are innately biased in favor of large populations. Until this bias is recognized, the development of viable models for care across the rural-urban continuum cannot move forward.