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David Hartley, PhD, MHA

David Hartley is with the Maine Rural Health Research Center, Muskie School of Public Service, University of Southern Maine, Portland.

Correspondence: Requests for reprints should be sent David Hartley, PhD, MHA, Muskie School of Public Service, University of Southern Maine, PO Box 9300, 509 Forest Ave, Portland, ME 04104 (e-mail:davidh{at}usm.maine.edu).

In this commentary, I place the maturing field of rural health research and policy in the context of the rural health disparities documented in Health United States, 2001, Urban and Rural Health Chartbook. Because of recent advances in our understanding of the determinants of health, the field must branch out from its traditional focus on access to health care services toward initiatives that are based on models of population health.

In addition to presenting distinct regional differences, the chartbook shows a pattern of risky health behaviors among rural populations that suggest a "rural culture" health determinant. This pattern suggests that there may be environmental and cultural factors unique to towns, regions, or United States Department of Agriculture (USDA) economic types that affect health behavior and health.

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