Rural Public Health Preparedness:
Setting the Agenda for Change
Michael Meit, MA, MPH, Director, University of Pittsburgh Center for
Rural Health Practice; Co-Director for Rural Preparedness,
University of Pittsburgh Center for Public Health Preparedness
Developing an Agenda for Change
Topics & Facilitators:
Building Capacity
Barbara Quiram, PhD, Texas A&M School of
Rural Public Health
Research
Michael Meit, MA, MPH, University of
Pittsburgh Center for Rural Health Practice
Advocacy
Janet Place, MPH, University of North Carolina
School of Rural Public Health
Setting an Agenda for Change
Building Capacity
Issues:

Limited human and financial resources to build
necessary infrastructure
 Limited understanding of “rural public health”
and how it is practiced
 Absence of leadership
Setting an Agenda for Change
Building Capacity
Recommendations:

Workforce and Leadership Development






Integration of rural PH preparedness knowledge into all health
professions training
Educational development beginning in K-12
Workforce development that extends beyond health professionals
Identify and engage stakeholders in the rural preparedness dialogue
Identify model training/leadership development programs
Educational Outreach


Direct educational initiatives toward government agencies and
personnel to enable them to make informed decisions
Inform policy-makers on best practices that demonstrate importance
and value of strategies utilizing rural resources
Setting an Agenda for Change
Research
Initial work for the research
topic was taken from the
Rural PH Research Agenda,
developed in 2004.
Preparedness was one of 6
topics in this report, which
formed the basis for the
research discussion in St.
Paul.
Setting an Agenda for Change
Research
Issues:

Lack of state and local PH response capacities in
some rural areas
 Lack of uniformity in state and local PH systems for
planning consistency
 Identification of the expanded rural PH system for PH
response
 Identification of necessary competencies in rural PH
response
 Perceived low threat of rural PH emergencies
 Need for model practices in rural PH response
 Lack of an organized rural PH constituency
Setting an Agenda for Change
Research
Priority Research Questions
1. How is government organized (i.e., different state/regional/local
models) across the U.S. to assure accountability for preparedness
in rural areas and what are the implications for incident command,
allocation of funding, cross-jurisdictional response, etc.?
2. What components/functions of preparedness are currently and
should be provided by rural communities? How are rural
communities mobilizing and organizing resources (including people
to fulfill those roles and responsibilities?
3. Who comprises the response network and what competencies are
necessary for readiness? What are the most effective training
methods?
Setting an Agenda for Change
Research
Priority Research Questions
4. Is the perception of the likelihood of bioterrorist and other public
health emergency threats different in rural vs. non-rural (urban,
suburban) areas? Between rural areas? Does the perception of
threat affect the level of preparedness?
5. What lessons have been learned from previous public health
response experiences/events that are applicable to our currents
efforts to strengthen rural preparedness? How can those lessons
influence/inform models of preparedness, readiness evaluation
tools, training strategies, etc?
Setting an Agenda for Change
Research
Recommendations:

Development of Infrastructure to Support Research



Need for dedicated funding to support “Rural Public Health”
research activities, both from federal agencies and
foundations
Specific CDC focus on rural public health issues; specific
focus among agencies such as FEMA, DHS, DOJ and others
on rural PH preparedness
Enhance “prestige” of rural research through development of
dedicated rural public health journal and encouraging existing
RH and PH journals to include more rural PH content, creation
of a national rural PH conference, and enhanced funding
opportunities for rural PH researchers.
Setting an Agenda for Change
Research
Recommendations (Cont.):

Research Strategies









Demonstration projects, including across jurisdictions
Highlighting case studies and best practices
Developing adaptable templates for program implementation
Focusing on community-participatory strategies
Increasing linkages among researchers, and between researchers and
community partners, including elected officials
“Mining” current data sets and summarizing current information
Conducting research that can be easily translated into policy
Enhancing communications among researchers with an interest in rural
PH – creating a network of rural PH reseachers
Creating measurable objectives for rural PH research with easily
identifiable goals
Setting an Agenda for Change
Research
Recommendations (Cont.):

Research Advocacy





Need to advocate for rural PH research as a unique and
necessary priority area within the field of public health
Work with the Federal Office of Rural Health Policy to
advocate within the federal government
Work with national RH and PH organizations to create a strong
legislative recognition of (and focus on) rural PH issues.
Create a rural PH constituency/voice.
Educate legislators, the rural caucus, agency heads, and PH
researchers themselves on rural health issues
Ensure a particular focus on CDC, which should be a much
stronger voice for rural PH
Setting an Agenda for Change
Advocacy
Issues:

Lack of an organized rural PH constituency
 Rural citizens are a large, disparate group
 Lack of understanding of PH in general, much
less how it can be applied in rural settings
Setting an Agenda for Change
Advocacy
Recommendations:








Need for broad focus on rural PH, with preparedness as a subset of
that focus – e.g., highlight general surveillance and epidemiology
challenges in rural areas, highlighting implications for preparedness
Broadly define preparedness to include infectious disease, food safety,
and natural disasters.
Do not create an “us vs. them” mentality
Focus on unique rural concerns such as water and food supply,
access to healthcare, energy sources, etc.
Highlight challenges related to the public health workforce, including
recruitment and retention issues
Enhance general understanding of public health among policy makers
– if they don’t understand PH, there’s little opportunity to educate
about rural PH
Create a grass-roots rural public health movement – from there create
and organized constituency at the local, state and federal levels
Use business models to frame importance of investing in rural PH
For more information contact:
Michael Meit
Director
University of Pittsburgh Center
for Rural Health Practice
300 Campus Drive
Bradford, PA 16701
Phone: (814) 362-5050
Fax:
(814) 362-5044
Email: meit@pitt.edu
www.upb.pitt.edu/crhp