in Rural America
PROCEEDINGS OF A WORKSHOP
Anna Nicholson, Rapporteur
Roundtable on Population Health Improvement
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by contracts between the National Academy of Sciences and Aetna Foundation, Association of American Medical Colleges, Blue Shield of California Foundation, BlueCross BlueShield of North Carolina, The California Endowment, Fannie E. Rippel Foundation/ReThink Health, Geisinger, The Kresge Foundation, National Association of County and City Health Officials, Nemours, New York State Health Foundation, Robert Wood Johnson Foundation, Samueli Foundation, The University of Texas at Austin, Thomas Jefferson University, and Wake Forest Baptist Medical Center. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-68527-6
International Standard Book Number-10: 0-309-68527-3
Digital Object Identifier: https://doi.org/10.17226/25989
Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2021 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2021. Population health in rural America in 2020: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25989.
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PLANNING COMMITTEE ON POPULATION HEALTH IN RURAL AMERICA IN 20201
TOM MORRIS (Chair), Federal Office of Rural Health Policy, Health Resources and Services Administration
MICHAEL BIRD, Indian Health Council
ALVA FERDINAND, Southwest Rural Health Research Center, Texas A&M University
ALANA KNUDSON, Walsh Center for Rural Health Analysis, NORC at the University of Chicago
JOSÉ T. MONTERO, Center for State, Tribal, Local, and Territorial Support; Centers for Disease Control and Prevention
KAREN MURPHY, The Steele Institute for Health Innovation, Geisinger
LARS PETERSON, Rural & Underserved Health Research Center, University of Kentucky
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
SANNE MAGNAN (Co-Chair), Senior Fellow, HealthPartners Institute
JOSHUA M. SHARFSTEIN (Co-Chair), Associate Dean for Public Health Practice and Training, Johns Hopkins Bloomberg School of Public Health
PHILIP M. ALBERTI, Senior Director, Health Equity Research and Policy, Association of American Medical Colleges
DAWN ALLEY, Chief Strategy Officer, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services
JOHN AUERBACH, Executive Director, Trust for America’s Health
CATHY BAASE, Chair, Board of Directors, Michigan Health Improvement Alliance; Consultant for Health Strategy, The Dow Chemical Company
RAYMOND BAXTER, Trustee, Blue Shield of California Foundation
DEBBIE I. CHANG, President and Chief Executive Officer, Blue Shield of California Foundation
MARC N. GOUREVITCH, Professor and Chair, Department of Population Health, New York University Langone Health
GARTH GRAHAM, President, Aetna Foundation
MEG GUERIN-CALVERT, Senior Managing Director and President, Center for Healthcare, Economics and Policy, FTI Consulting
GARY R. GUNDERSON, Vice President, Faith Health, School of Divinity, Wake Forest University
DORA HUGHES, Associate Research Professor of Health Policy and Management, Milken Institute School of Public Health, The George Washington University
SHERI JOHNSON, Director, Population Health Institute; Acting Director, Robert Wood Johnson Foundation, Culture of Health Prize; Associate Professor, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin–Madison
WAYNE JONAS, Executive Director, Integrative Health Programs, H&S Ventures; Samueli Foundation
ROBERT M. KAPLAN, Professor, Center for Advanced Study in the Behavioral Sciences, Stanford University
MICHELLE LARKIN, Associate Vice President, Associate Chief of Staff, Robert Wood Johnson Foundation
1 The National Academies of Sciences, Engineering, and Medicines planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
MILTON LITTLE, President, United Way of Greater Atlanta
PHYLLIS D. MEADOWS, Senior Fellow, Health Program, The Kresge Foundation
BOBBY MILSTEIN, Director, ReThink Health
JOSÉ T. MONTERO, Director, Center for State, Tribal, Local, and Territorial Support; Deputy Director, Centers for Disease Control and Prevention
WILLIE (BILLY) H. OGLESBY, Interim Dean, Jefferson College of Population Health, Thomas Jefferson University
JASON PURNELL, Associate Professor, Director, Health Equity Works, Brown School, Washington University in Saint Louis
RAHUL RAJKUMAR, Senior Vice President and Chief Medical Officer, BlueCross and BlueShield of North Carolina
LOURDES J. RODRIGUEZ, Senior Program Officer, St. David’s Foundation
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
KOSALI SIMON, Herman B. Wells Endowed Professor, Associate Vice Provost for Health Sciences, Paul H. O’Neill School of Public and Environmental Affairs, Indiana University
HANH CAO YU, Chief Learning Officer, The California Endowment
Health and Medicine Division Staff
ALINA BACIU, Roundtable Director
CARLA ALVARADO, Program Officer (through January 2021)
HARIKA DYER, Senior Program Assistant
AYSHIA COLETRANE, Senior Program Assistant (from October 2020)
ROSE M. MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
ANNA NICHOLSON, Rapporteur
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by MARTIN J. SEPULVEDA, IBM Corporation. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Boxes, Figures, and Table
|ACO||accountable care organization|
|AHRQ ATHS||Agency for Healthcare Research and Quality Alaska Tribal Health System|
|BPC||Bipartisan Policy Center|
|CAH||critical access hospital|
|CARES||Coronavirus Aid, Relief, and Economic Security|
|CCCHC||Coal Country Community Health Center|
|CDC||Centers for Disease Control and Prevention|
|CDC WONDER||CDC Wide-ranging Online Data for Epidemiologic Research|
|CHNA||community health needs assessment|
|CHR||community health representative|
|CHW||community health worker|
|CMS||Centers for Medicare & Medicaid Services|
|COPD||chronic obstructive pulmonary disease|
|COVID-19||coronavirus disease 2019|
|EHR||electronic health record|
|FQHC||federally qualified health center|
|HHS||Department of Health and Human Services|
|HRSA||Health Resources and Services Administration|
|IBH||integrated behavioral health|
|ICU||intensive care unit|
|IHCIA||Indian Health Care Improvement Act|
|IHS||Indian Health Service|
|KFF||Kaiser Family Foundation|
|OMB||Office of Management and Budget|
|PPE||personal protective equipment|
|PPP||Paycheck Protection Program|
|RAP||recommendation adoption progress|
|SBA||Small Business Administration|
|SDOH||social determinants of health|
|SMC||Sakakawea Medical Center|