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| Chart from NACCHO report; a similar chart in the report shows services and programs more prevalent in rural areas. |
Local health departments serving rural jurisdictions are less likely to provide regulation, inspection, and licensing services, as well as environmental health services, with the exception of regulating public drinking-water supplies, according to a report from the National Association of City and County Health Officials.
The report, based on a survey of local health departments, found several other disparities. Rural health departments are less likely to be involved in preventing sale of tobacco products, including electronic cigarettes, to minors; are half as likely as their urban counterparts to recruit employees from academic institutions; and are three to four times less likely to use social media, other than Facebook, which more than 80 percent of both types reported using.
On the other hand, "Local health departments serving rural jurisdictions are more likely to provide certain clinical services, including childhood and adult immunizations, maternal and child health services, and screening/treatment for various conditions," and they get more funding per person than their urban counterparts, the report says.
"The difference in clinical revenues among rural and urban LHDs is particularly striking (mean of $21 per capita for rural jurisdictions versus $6 per capita for urban jurisdictions)," the report says. That likely reflects a shortage of health-care providers in many rural areas and a higher reliance on local health departments. One funding source is the federal Women, Infants and Children nutrition program, in which 76 percent of rural health departments responding to the survey participate, compared to 59 percent of urban departments responding.
Departments were coded as urban or rural based on whether the majority of people they serve live in from urban or rural census tracts. Many rural census tracts are in metropolitan areas.
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