![178: Rural health challenges and opportunities, Part 1: A conversation with the CDC and HHS]()
October 22, 2024
178: Rural health challenges and opportunities, Part 1: A conversation with the CDC and HHS
People in rural areas have higher rates of certain chronic conditions and disabilities and can expect to live a couple years shorter, on average, compared to people in urban areas. The health disparities facing rural Americans stem from many factors – including geographic, economic, social, and systemic issues.
But in the midst of all this, there is hope. There’s greater awareness of the importance of rural health care and public health resources, and a growing number of federal agencies dedicated to supporting data-driven solutions aimed at addressing rural health challenges.
Two individuals behind some of those efforts join the Health Disparities podcast to discuss rural health challenges and opportunities:
“There's been a lot of focus on access to health care in rural areas, which is absolutely incredibly important,” Hall says. “But I also think we need to really pay attention to the public health infrastructure, which has also been decreased because of budget issues [and] because of the impact of the pandemic.”
Addressing rural health needs is a bipartisan issue, says Morris.
“There may be disagreements about how you get to the outcome, but there's no disagreement about what the challenges are,” Morris says. “...The partisan divide sort of falls apart when you dive into the issues.”
Morris and Hall speak with Health Disparities podcast host Bill Finerfrock about the priorities of their respective offices, common myths about rural America, and what gives them hope as they consider the future of rural health.
Never miss an episode – be sure to subscribe to The Health Disparities podcast from Movement Is Life on Apple Podcasts, YouTube, or wherever you get your podcasts.
The transcript from today’s episode has been lightly edited for clarity.
Diane Hall: So if we say on this indicator, say heart disease or stroke or blood pressure, whatever, rural is lagging non-rural by whatever percent. That's not very actionable. It's also probably not very accurate because rural isn't one thing. But if we dig into the data and look at it more, we will probably find that there are differences by race and ethnicity, by age, by gender, by disability status. And if we can do more of those analyses, the work can become more actionable.
Bill Finerfrock: Welcome, everyone. You're listening to the Health Disparities Podcast from Movement is Life. I'm Bill Finerfrock, a member of the Board of Directors for Movement is Life and the co-founder and former executive director of the National Association of Rural Health Clinics.
We're joined today by two individuals I've known for a good number of years. Tom Morris is the director of the Federal Office of Rural Health Policy. And I think I've known Tom for certainly over twenty five years, probably approaching thirty years. Diane, I haven't known quite as long, but I have known her for several years as well. Diane Hall is the director of the Centers for Disease Control and Prevention's Office of Rural Health.
People in rural areas, we know, have a higher rate of certain chronic conditions and disabilities and can expect to live a few years shorter on average compared to people who live in urban areas. The health disparities facing rural Americans stem from many factors, including geographic, economic, social, and systemic issues. And that's gonna be the focus of today's podcast.
In the midst of this, though -- and I think this is always important because very often in rural health, we always talk about, oh, you know, we have this problem, we have that problem -- there's a lot of good news and there's a lot of good reasons why people want to and should consider living, working and playing in rural America. They're creating more equitable access to care in rural America. We're seeing various programs and initiatives.
And I'm joined by two people who are at the forefront of that arena. Tom is the director of the Federal Office of Rural Health Policy, has been directing for a number of years federal initiatives aimed at improving access to health care, working with in particular the Center for Medicare and Medicaid Services. And then Diane is looking more at the health issues that are confronting.
I'm going to start off with Diane first as the CDC's Director of Rural Health. What are you folks at CDC seeing in the way of some of the issues, the health issues that are confronting rural America? And what are some of the things that we might be able to look at or consider doing in response to that?
Hall: Well, at CDC, we always try to start with data so that we can better understand the challenge in various communities. That could be a whole separate podcast just talking about rural communities and data. So we'll table that for a future conversation. But for this conversation, I'd like to highlight some of the work that our office is doing.
Currently, what we're doing is working on developing a resource for public health researchers and practitioners that will provide information on CDC datasets that include rural geography as a variable, and we will provide step-by-step instructions on using some of our datasets, starting with the National Vital Statistics System, the Behavioral Risk Factor Surveillance System, and the National Health Interview Survey. This resource will include additional information about the different definitions of rural – and again, that could be a whole separate podcast episode, maybe series – but also step-by-step instructions on how to access CDC's data.
We know that it can be very challenging at times. So we're working with external partners to develop those directions to make it easier for people to access those data. The idea is that we want to put data in the hands of decision makers. Without data, it can be really hard to figure out what kind of program or communications initiative or what challenge your community is facing. Having data is always a really good place to start.
One of the other things that we do, and our office will be focusing on this more, CDC has a flagship publication called the Morbidity Mortality Weekly Report or MMWR. And in April of this year, we published an update of work that we started in 2016, where we looked at the leading causes of death and looked at mortality. So we did that report in 2017, 2019, and this is a way for us to continue to add years so we can look at trends over time, but also look at individual state data.
There's been a lot of focus on access to healthcare in rural areas, which is absolutely incredibly important. But I also think we need to really pay attention to the public health infrastructure, which has also been decreased because of budget issues, because of the impact of the pandemic, etc. And we know that in rural areas, public health departments are a vital part of that safety net that people in rural communities rely on to become healthy or to see somebody when they're sick. We know that people in rural areas really depend on those health departments for critical programs and services, such as immunizations, screenings for the chronic illnesses that you mentioned, Bill, but also maternal and child health services.
And part of that infrastructure really requires thinking about pipelines and training. And CDC has a training program called the Public Health Associate Program, or PHAP, and my office has been working with the PHAP office and external partners to try to increase the number of rural host sites. We believe that this is a way to start to build back some of that public health capacity. Essentially, it's a match program for early career professionals, but CDC provides the salary and benefits and mentorships, but the associate is housed locally. So that's just a few different things that we're focusing on.
Finerfrock: Excellent. Tom is the Dean of Offices of Rural Health, and we actually have several of them going at this point in different agencies or sub-agencies. How does the Federal Office of Rural Health policy take data or the information you get, and how do you try to translate that into action? And kind of explain to our audience what your role in all of this is.
Tom Morris: Sure. I think the easiest way to explain it is, you know, what we try to do is invest in research that we can then use to inform our program. So we're lucky enough in the office to have a fairly robust budget. And we have grant programs that go to the state level and also the community level. And I think what they're all about in their core is that capacity building at those two areas. And so we also fund a rural services research program.
We're constantly trying to use what we learn in our research to inform our program, but then also vice versa. Issues will come up through our various grant programs that we think need more research, and we'll feed that into our research center. The nice thing about having both of them under one roof is that they really do interact quite a lot.
I'll give you a good example of that. We just recently, through our research center at the University of Minnesota, released a, rural counties have been losing obstetric units in their hospitals at a really concerning pace for the last probably fifteen years. And so, you know, that obviously creates some challenges because even if you close your OB unit in a rural hospital, there are still some times where you're going to be delivering a baby because it's an emergency situation. And so looking at that data and realizing that the numbers were going in the wrong direction, we designed a pilot program that eventually the Congress authorized to do a full program to basically look at regional solutions to obstetric and maternal care.
And so what we're trying to do is get more rural women into prenatal care early and often, risk triage, deliver closer to home and then sort of care for them throughout the course of the pregnancy and then one year postpartum. And so right now we've got about fourteen grants across the country where we're doing this. The early results have been promising. This is not easy work to do, but we can make a difference, I think, in terms of saving money because you'll have shorter term stays.
Medicaid is the dominant payer for deliveries in this country and certainly in rural communities. And so, for example, if we can just save one neonatal intensive care state unit, we'll have paid for the entire grant that we gave to that regional consortium. And so that's an example of where we saw some data that informed what we do in terms of program design and delivery.
Finerfrock: You both have touched a little bit on kind of the workforce, I mean, Tom, what you're just talking about in terms of losing OB-GYN, Diane, you talked about, you know, programs you're looking at to try and get more public health officials. Is that a critical part of, for both of you, really how do we get people into rural communities? How do we get health professionals to go to those communities? And what do you see as some of the barriers? Is it just the money issue, pay them more and they'll go? Or what are some of the challenges of getting health professionals, whether it's public health or OB-GYN, primary care providers into the communities? Tom, do you want to take that one first?
Morris: I'll get started. I mean, I think, you know, you could answer this better than Diane or I both, I think. Yeah, I think that it's a complicated challenge, and it's been a challenge for rural communities forever. You know, the fact is it's a little different practicing in a rural community. They have less support in many cases. You know, there are just a host of reasons why we struggle to attract the full range of needed health care professionals in rural communities. Some of it may be reimbursement. Some may be the context of the care and not having support. Some of it may be the way we train folks. You know, a lot of our academic units that train doctors and nurses and dentists are all in very urban, metro areas. There are studies showing that you tend to practice near where you finish your training. So I think that there's no one single solution to it.
I think certainly the better you pay people, the more likely they are to stay. But if pay alone was the issue, I think we would have taken care of this a long time ago. I think the real key is trying a lot of things. And you often hear of ‘growing your own’ strategies where you take folks from rural communities that are more appreciative of the lifestyle and more likely to want to practice there. That's one way. But we also know that if we expose students to training, even if they're from an urban area, we don't need a big yield. If you send ten nursing students to rotate through a rural public health department or a health clinic or a rural hospital, if you can get two of them to stay, that's a ratio I'll take every time. And so I think it's just a matter of really trying as many different things as possible. I can't really speak as well to the public health side, but I know Diane can.
Hall: And as a public health person, I'm actually going to zoom out a little bit and focus a little bit more on communities. Tom and I both do a lot of travel to different rural communities. And one of the things that we've been hearing regularly, regardless of the community, is that there are challenges around transportation and housing. So that just isn't for people who are patients of the health care system. That also affects people that would be living in those communities.
So Tom and I were in Bertie County, North Carolina, last year, I think it was. And the county has a lot of jobs open, but they were having a really hard time attracting early career professionals. And this wasn't just jobs in healthcare. This was also teaching positions and other really critical roles in a community. And they were able, and I don't know how they did it, but they were able, they decided to build their own apartments. So they created their own apartment complex so that they can actually compete with some of these other places because there are early career professionals or young families who would like to live in a rural area, but the housing and the transportation or the daycare issues can get in the way. And that's true also for other personnel working at the hospital. It's not just the provider, it's the lab techs, it's the people that work in dietary, those kinds of things.
So if we zoom out and think about the whole community, we really need to also be tackling the housing, the transportation, the schools, the daycare, all of those things. That's what people look for when they move into a community.
Finerfrock: Well, and even when you're looking at putting students out there, I mean, one of the things that we've looked at with the rural health clinics is to say, well, we need to get more students to go out and do clinical rotations in rural health clinics in order to expose them for the reasons you mentioned, Tom. But you have the same challenge. It's like, well, where do I live when I'm out there? How do I get there? What are the transportation and housing issues that I'm gonna confront, whereas, because my educational program is in, let's say, Washington, DC, well, I can easily do all my clinical rotations within a subway ride. If I wanna go out to West Virginia, to a rural area to do a clinical rotation, whether it's PA, MD, public health, you know, you have all these other issues which create barriers to students going out and getting exposure to those environments, which then decreases the likelihood that they're going to choose to practice there once they've graduated from their program.
We hear a lot about, you know, as a friend, I'm blanking on who it was, but you used to always say, you know, once you've seen one rural community, you've seen one rural community. And there is this general idea that rural is just rural, but it isn't. You have rural areas where you have, and it's often said, ‘oh, it's just all these Caucasian rural farmers.’ Well, the makeup of rural America is much more diverse. Can you talk about that, the diversity of rural areas and what those challenges present to policymakers trying to address it? It's not this monolithic, just rural, it's a very diverse community.
Hall: There's this fascinating article from several years ago. I've forgotten the reference. I will get it to you so it can go in the notes or whatever. And these researchers looked at economic factors and population inflow and outflow. So there are so many definitions of rural, and that would be another podcast series. And it's very technical, but this paper was taking an innovative approach to thinking about rural communities. And what they found is that there are rural communities that are absolutely thriving.
When we think about rural, we tend to think about poorer, sicker, older. But there are rural communities in the United States that are doing really well. And a lot of times those are communities that have great outdoor amenities. It's where a lot of wealthy people like to have a second home, so it's not exactly affordable. But it sort of disrupts that stereotype of rural a little bit in a different kind of way.
And then the other end of the spectrum is sort of the chronic poverty, historically poor, and this is traditionally, you know, we think about the Black Belt in the Old South in the U.S. These are communities that have been really challenged for a long time, impoverished, and they're losing population. And then there's that middle group, because there's always a middle group that's sort of transitioning one to the other.
I think we need to broaden how we think about rural communities. When we think about trying to identify with communities potential strategies to address needs, one of the things I'm hoping we can do more of at the agency here is look at that within rural variation. So if we say on this indicator, say heart disease or stroke or blood pressure, whatever, rural is lagging non-rural by whatever percent. That's not very actionable. It's also probably not very accurate because rural isn't one thing. But if we dig into the data and look at it more, we will probably find that there are differences by race and ethnicity, by age, by gender, by disability status. And if we can do more of those analyses, the work can become more actionable. It doesn't make sense to do a public health campaign or communications campaign without having that kind of information, because you want to try to target your audience as much as you can.
Finerfrock: Tom, are you seeing the same thing with the Federal Office of Rural Health Policy and what's your perspective on that?
Morris: Yeah, I agree with everything Diane said. I mean, I've seen two studies, first by Brookings then by a group out of Vermont the last couple of years that are tracking the growing diversity in rural communities. They're not diversifying as fast as urban areas but they're diversifying faster than they have in the last say twenty years than they did the prior couple of decades.
And so what we see now is one in five rural residents is a member of a racial or ethnic subgroup. And so the reason that's important is because you don't want to play in that myth of, well, one size fits all. If you don't take into account your population, like we talked about some of the different sectors, Diane was mentioning, whether it be gaining population or otherwise, we have places in the Midwest that were not for the influx of Hispanic residents would have been net loss population for the last two censuses. And so if you're going in there to do a project and you don't take into account that it's a largely Hispanic population, you're going to have the wrong answer for the right problem. And so I think you have to take that into account as we design things.
We have a tendency, I think, in this country, unfortunately, to say, you know, rural is just a smaller version of urban. And that's not true. It's not true from the population standpoint. It's not true from a resource standpoint. And so really the solutions, they need to have enough flexibility to be tailored to that community's particular needs. And I think that's one of the things we're learning is that we don't have to test out models in urban areas all the time. We can test them out in rural. And even if you do that, to Diane's point, just because it worked in one rural community doesn't mean it can be plopped into another one. You're gonna have to adapt it to that local community. And so this awareness of increasing diversity, I think is an important part of future policy and program design.
Finerfrock: Yeah, I think, you know, I'm not originally from rural America in terms of where I grew up. It's kind of what I've learned in traveling around the country, but you're absolutely right. I mean, rural Montana is different than rural Vermont, is different than rural North Carolina, is different than rural Mississippi. And, you know, the influx and outflux of people, you know, just even on a temporary basis in terms of migrant workers, migrant farm workers coming into a community for a short period of time and leaving. What strains does that put on the healthcare delivery system as well as the public health system in terms of people coming in potentially bringing different diseases or different conditions? It's a very complex problem and it's not as simple, I think that's one of the myths of rural. Are there other myths or areas where you think that people don't really fully understand the complexity of dealing with rural health and rural communities?
Hall: So I think one of the things people overlook is they often think about rural in terms of geography, and they're not really thinking about the cultures and the traditions and the connection to place, which is absolutely vital. And that's another reason that rural is not the same. So you said Montana is not like Vermont. Absolutely not. There are social, historical, political considerations that are part of the fabric of that community. There's a relationship with land or with water, with the outdoors that you don't see in an urban area. So I think people overlook that a lot of times.
We think about distance. Oh, it's so far away. Well, Vermont has rural areas. Connecticut has rural areas. Distance is probably not the biggest issue, but there are other rural issues that are a challenge. I think one of the other, I don't know if it's a myth, but I think when we talk about rural health, we often default to talking only about healthcare, and we absolutely need to, but we also need to make sure that we've got that robust public health infrastructure and workforce because we want our rural communities to have clean water, clean air, access to healthy foods, and to be ready for the next emergency, whatever that's going to be.
And we need public health in rural areas so we can start to reverse these preventable early diseases we see. One of the things about public health is we like to emphasize primary prevention and stopping things before they start. So there's a critical role for public health to play and a lot of times people don't see that right off the bat.
Finerfrock: Tom, did you want to add anything?
Morris: I think the only thing I would add is that we live in such a polarized time. My experience in going to rural communities is rural health care is a bipartisan issue. There may be disagreements about how do you get to the outcome, but there's no disagreement about what the challenges are. And so, you know, I think we tend to paint rural America as one picture and urban America as another. And certainly those numbers, I'm not faulting the numbers, but I think they lack a precision in having a really robust discussion about rural health care because I think the partisan divide sort of falls apart when you dive into the issues.
Finerfrock: So in terms of distance, one of the things that we've heard, and it began to emerge really in a big way during COVID, was telehealth. And the, ‘oh, telehealth is the solution.’ ‘That's gonna be the answer for rural America. We don't have to get health professionals We just have to make sure that they have good internet connections and we can just,’ you know, but, you know, and my personal view is that certainly there's a role for telehealth, absolutely has a role, but it's not to replace the, there's still a need for boots on the ground for actual people in those communities. Can you kind of both address it from a, you know, from a resource standpoint or from a provider standpoint and from a public health standpoint, what do you see as the role of telehealth as far as moving forward?
Hall: Tom, you want to go first? I know you love that comment.
Morris: No, I've been working on telehealth issues since the day I moved to Washington. Even before that, I was working on it in grad school. when it was still sort of a nascent product. I think you said it perfectly, Bill. It's a really important tool. I worry sometimes that it can be seen as a panacea that avoids having to make the much more difficult sort of allocation of resources to build the infrastructure through which telehealth can then be leveraged. And I mean that not just in terms of connectivity, but also in terms of people. You still need clinicians on the ground and rural to connect to the clinicians that are specializing.
And I think it's really a broader technology issue. You know, remote patient monitoring is great. Telehealth is great, but you still have to have the infrastructure on the ground to really leverage it fully. So defer to Diane on the rest.
Hall: And I also think that the underlying issue about broadband in rural areas is critical. So telehealth is important. but I think access to the internet and to broadband is important for educational opportunities, other types of work opportunities. And we, some of us, have been talking about this almost as a determinant of health, because it gives you access to health information that you might not have otherwise. It can increase health literacy.
And so broadband access is about more than being able to access somebody during, needing a clinical appointment. So I agree with Tom. It's a tool that we can use, but it doesn't address all the issues. We still have workforce challenges regardless of where you are. And so telehealth presumes that you've got a professional to access someone you can reach out to. When you think about dental care or mental health care, we've got serious shortages in those spaces. Telehealth is not going to fix that.
Finerfrock: Yeah, I mean, telehealth, you know, there are certain things that telehealth can do great, but at some point you still need that tactile, that hands-on clinician who can really figure out what's going on with the individual. And it's not just simply through a camera. There were a lot of creative things that I saw during COVID, particularly with this access to the internet, I think it was South Carolina took school buses that weren't being used and put routers in school buses and sent them to various locations and just parked them all over the state to serve as this, you know, internet hub to improve access to the internet. So, um, but you know, you're right, you know, technology and telehealth has role, but it's not a complete substitute for the need to continue to get boots on the ground and people into these communities.
So I mentioned this earlier, so you're two of the offices of rural health. There are other offices of rural health as well. There's offices of minority health. Do you folks get together? I know Diane and Tom, you mentioned you were together down in North Carolina. Do you get together with other offices of rural health or other government agencies to coordinate and collaborate and see what they're learning and learn from one another?
Morris: Yeah, I think we do. I mean, before they created Diane's office, we were working together for several years and we've worked with, the VA has an Office of Rural Health. Most of the HHS subagencies have at least a lead person on rural health or somebody you can call to sort of navigate through that. And that emergence has really been in the last ten to twelve years. And so last year during National Health Day, we all got together on a call and did a webinar together. So, yeah, I think there are, it's really important that we connect as much as we can.
I mean, our approach, I think Diane has the same orientation as well, is like, anybody in HHS or government that wants to work on rural, we're happy to work with you. And so that's led us to a variety of interesting partnerships with the National Cancer Institute, with USDA. But I mean, the best example of a really robust partnership was the one that we were able to develop with CDC starting about 2017.
Hall: Yeah, I absolutely agree. There's plenty of work to go around and we are more than happy to collaborate with those that are interested. I think for me, one of the game changers was the creation of that rural liaison position at USDA. So the Farm Bill created a position at USDA for someone whose sole responsibility is to connect with HHS, because there's so many different connections between the divisions of HHS, Health and Human Services, and USDA. We're just talking about housing. We've been talking about infrastructure. USDA funds a lot of those things in rural areas. And now having one person to go to at USDA, which is a large agency, has been a game changer for us. We do so much collaboration. We wouldn't be able to get the work done otherwise.
Finerfrock: So if each of you had to pick, what you think was the biggest success you've had in your respective positions? And then also, how do you see the future? Where do you see this going? Are you optimistic? Are you pessimistic? Where do you see us in two, three years from now?
Hall: So my office is kind of, we're the new kid on the block. I think the Federal Office of Rural Health Policy has thirty years on us, maybe thirty more than that on us. But one of the things that's so great about the staff in the Federal Office of Rural Health Policy is that they've really blazed the trail for us. We don't need to do that. And they're so collaborative. So Tom's Office funds the Rural Health Information Hub, and the National Rural Health Association, and the State Offices of Rural Health, those are all really critical partners for us to work with. And they've all been incredibly generous with their time, helping us get up to speed and think throughL What is it that CDC should be doing more of in this space? They were absolutely vital in the development of our first ever agency strategic plan for rural public health, which will be coming out in the next few months.
In terms of biggest success, honestly, I have to say it's receiving appropriations from Congress for CDC to stand up this office. We've always done work in rural health, but it's existed at the program level. And that means it's been sort of scattered throughout the agency. In 2017, we made a decision to try to talk more about the agency's portfolio of work and trying to coordinate more. But having this office provides us with visibility and essentially a mandate. And that has been amazing. So I would say that's the biggest success to me. It was a recognition that CDC had important work to do in this space. It's recognition that rural health really is a bipartisan issue and that we've got a lot of folks on the Hill that support improving the lives in rural communities and improving health of rural communities.
Finerfrock: So, Tom, I'm going to take you off the hook just a little bit, because asking you to pick your favorite would be like asking you to pick your favorite child, right? So instead of saying your favorite or what you're proud of, talk about one of your successes, because you've had many that you look at and the audience can be aware of.
Morris: Well, I think at a macro level, I'd probably point to the work of the Rural Health Research Centers, just because it's hard to have a conversation if you can't quantify the issue at hand. And so they've been around almost as long as the office, 30-plus years. But I think they're naturally recognized as a go to resource. And so I see their work gets cited all over the place. And, you know, to the extent there's a recognition that rural services research is unique. I think it's due to their work on a micro level.
One of the things we pride ourselves on is being very agile and creative, which is not always what you hear with the federal government. So I'm going to sort of put that in context. But a few years back, we were able to work with the community in Libby, Montana, that was the site of the vermiculite poisoning. And they had a public health emergency. And it was a very sad situation. But the people there were wonderful. And all they wanted was some help and a chance to address the issue. And so working with some of Diane's counterparts at ATSDR, which I don't know the name of, but she will tell you. There are folks who deal with toxic substances and issues. We went in together and they did a big screening to help figure out who had gotten asbestos-related poisoning.
We then stood up an insurance benefit for all those affected so that they could get healthcare services covered. And we did that as a bridge so that when the Affordable Care Act passed and gave all of those with that diagnosis Medicare eligibility I felt like we made a real difference there and making sure that one people got diagnosed with the disease and then if they were diagnosed that we were able to provide a bridge to treatment for them. So I think it's also a good metaphor for the way we try to operate you know if there's a challenge that we can help people with, we want to definitely do that.
Finerfrock: Yeah, and I mean, I can speak personally. I mean, the Federal Office of Rural Health Policy has really been an amazing agency and the focus and the resources that they've been able to direct to rural communities. And I think, you know, the flexibility issue that you addressed and just their willingness to reach out and be helpful and kind of like, you know, mean it. I mean, you know, there was always that tagline. I'm from the federal government. I'm here to help, it was always kind of like, ‘oh, yeah, right.’ But in the case of the Federal Office of Rural Health Policy, I always felt that that was true. And I think, Diane, you've tried to keep that same kind of mantra is, you know, we're here to help.
And I'm glad you brought up the appropriation because it gives me the opportunity to say thank you for the work that you've done. I mean, because I don't believe that the Office of Rural Health in CDC would exist if it were not for you and the work that you were doing without portfolio, if you will, and really demonstrating to people why it was necessary to have an Office of Rural Health at CDC. And so the success that you've had and the recognition that you've gotten from Congress is really you laid the foundation for that.
And you're right, Tom and the folks, I think, you know, the Federal Office of Rural Health Policy is like the first child, right? I grew up in a family of five. And the way my parents dealt with my older brother was vastly different than they dealt with the fifth child, our youngest sister. She got away with murder, right? She didn't have to go through all the struggles and the challenges that my older brother had to go through or I, as the second child, had to go through. And so federal office of rural health policy really kind of broke down a lot of barriers, educated a lot of people, so that subsequent agencies and folks downstream didn't have to fight some of the same battles that they had to fight and win, but are allowing you guys to have the success that you're having.
So kudos to both of you for the work that you've done in your respective offices. As we wrap this up, is there anything that we haven't touched on that you'd like our audience to be aware of in terms of your work or where you see things going or what are some of the challenges?
Morris: I think the only thing I would add is I just think there's a much more general awareness of rural health as an issue now in the last handful of years than I've seen throughout my career. There's a lot more media coverage to it. There's a lot more attention to it. We're seeing it reflected in the creation of Diane's office. We're seeing it reflected in the increasing amount of our budget, recognizing that sometimes we need rural-targeted solutions. But I'm also seeing it in the interest of the congressional committees and national think tanks and things like that.
So I think we're in a good place in rural health, there’s obviously a lot of challenges left, but, you know, we're no longer pushing it up such a steep hill. It's leveled out a bit and that's made it easier.
Hall: Yeah, I agree. It's so gratifying to have such amazing partners and collaborators in this work. As I mentioned, there's a lot of work to do, but there are a lot of great partners who are so generous with their time and knowledge. And it's just been a great experience getting to know everybody and being able to start to work in the space.
Finerfrock: Great. Well, for our audience, if you want to learn more about HHS's Federal Office of Rural Health Policy and CDC's Office of Rural Health, you'll have links in our show notes that you can look and see some of the other things that they're doing that we didn't touch on.
I'd really like to thank Tom and Diane for joining us today. I really appreciate it. This is, as I had mentioned to you, this is a part, and for our audience, of a series that we're going to be doing that will come out later, we’re recording this earlier. And we're going to look at what are some of the solutions to the rural health issues. We're going to be talking with some rural providers about what they're seeing in terms of boots on the ground and in their communities to really try and highlight and direct some attention to this area.
So thank you, Tom, and thank you, Diane, for everything that you're doing in your agencies for people in rural America. Chances are a lot of people don't know who you are. but by the same token, they have access to healthcare or they have access to other services that they might not otherwise have if it weren't for the work that you and your colleagues are doing in your respective offices. So thank you very much for taking time to talk with me today and be on the Health Disparities podcast here with Movement is Life.
As we conclude, I'd like to also put in a plug for our upcoming annual summit. It will be held in Atlanta, Georgia. This year will be Thursday, November 14, to Friday, November 15. And we'll be at the Whitley Hotel in the Buckhead area of Atlanta. Again, you can go to our website and find more information. I'm Bill Finerfrock. Until next time, be safe and be well
CATEGORIES: Podcasts