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January 2005, Vol 95, No. 1 | American Journal of Public Health 42-48
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.047597

HEALTH POLICY AND ETHICS

Workforce Issues in Rural Areas: A Focus on Policy Equity

Thomas C. Ricketts, PhD, MPH

Thomas C. Ricketts is with the Department of Health Policy and Administration, School of Public Health, and the Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill.

Correspondence: Requests for reprints should be sent to Thomas C. Ricketts, PhD, MPH, Sheps Center UNC CB# 7590, Chapel Hill, NC 27599-7590 (e-mail: tom_ricketts{at}unc.edu).

Rural communities in the United States are served by relatively fewer health care professionals than urban or suburban areas.

I review the geographic distribution of 6 classes of health professionals and describe the multiple government and private policies and programs intended to affect their geographic distribution. These programs can be classified into 3 categories—coercive, normative, and utilitarian—that characterize the major policy levers used to influence practice location decisions.

Health workforce policies must be normative to ensure equity for rural communities, but goals in this area can be achieved only through a balance of utilitarian and coercive mechanisms.




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