Rural health priorities in America: Where you stand depends on where you sit

Purpose: To assess levels of agreement on priority areas among state and local rural health leaders nationwide. Methods: Analysis of responses to a mail survey sent to 999 rural health leaders, with 501 responses. Respondents were asked to rank importance to rural health of focus areas named in Healthy People 2010. Findings: There was substantial agreement on top rural health priorities among state and local rural health leaders across the 50 states. "Access to quality health services" was the top priority among leaders of state-level rural agencies and health associations, local rural public health agencies, rural health clinics and community health centers, and rural hospitals. It was the top priority across all 4 major census regions of the nation as well. The next 4 top-ranking rural priorities-"heart disease and stroke," "diabetes," "mental health and mental disorders," and "oral health"-were selected as 1 of the top 5 rural priorities by one third or more of respondents across most groups and regions. At the same time, some observed differences in rural health priorities suggest opportunities for community partnership strategies or for regional multistate policy initiatives by states sharing similar rural health priorities.