A National Agenda for Rural Minority Health
An Issue Paper Prepared by the National Rural Health Association -- May 1999
In partnership with President Clinton's Initiative on Race, which has already made a national commitment to eliminate racial and ethnic disparities in six areas of health status for racial and ethnic minority populations by the year 2010, the NRHA in 1997 developed A National Agenda for Rural Minority Health. The purpose of this agenda is to address access gaps and the growing disparities in health status indicators for rural minority populations. The agenda is organized and developed around three priority areas:
The three priority areas are presented within the agenda as part of a strategic plan of action that includes objectives and implementation strategies. Also included is the process for identifying partners to participate in the agenda's formulation, implementation and evaluation steps, all of which are a necessary part of a national policy or issue of focus. The agenda is intended to serve as a document that can be used in a prescriptive manner by state and local health and health-related agencies for setting priorities and community funding for major rural minority health initiatives. It includes specifically focused vision statements and implementation strategies for use by multigenerational, rural minority communities into the next millennium. In keeping with the President's Initiative on Race, which sets a goal of "One America in the 21st Century," the NRHA believes we must prepare to live as one nation in the coming new century, with equal health status outcomes and expectations.
THE VALUE OF A NATIONAL AGENDA FOR RURAL MINORITY HEALTH
In 1993, a charge was given to the NRHA by the Rural Minority Health Advisory Committee to develop a dynamic document that could be implemented for the next five or more years-however long it takes to bring the changes to fruition. This process resulted in the following overarching values of a health care delivery system on which the agenda is based.
This value system serves as the framework on which the agenda's three priority areas are structured. These values also will serve to guide the final plan development and implementation process. Strategies that involve resources from sponsoring and funding agencies or interest groups, or administrative, technical and budgetary support to enact this agenda must incorporate these values as well. As we move forward into the 21st century, we must have clearly defined values and goals as well as commonly held ideals that will prepare our country to live as one nation.
THE THREE PRIORITY AREAS OF THE AGENDA
The structures of A National Agenda for Rural Minority Health are linked to three priority areas. This paper summarizes these areas of the agenda.
Information and Data
Currently there are sparse and inconsistent health-related data on rural minority populations. To reduce health disparities, there must be adequate data concerning the health status, health care patterns of utilization, health care financing and health outcomes for all rural and ethnic minority populations. Action steps recommended to facilitate these needs follow.
Health Policy and Practices
The goal is to achieve a system of health care that provides comprehensive health care services for multigenerational, rural minority populations. As part of the President's Initiative on Race, the elimination of health disparities has been formally acknowledged as a policy issue of top priority. The agenda recommends the following.
Health Delivery Systems
It is necessary to view health care as a right, not a privilege. Primary health care delivery systems must be developed that not only eliminate health disparities in six areas of health status for racial and ethnic minority populations, but also substantially improve the health status of these populations. To do so, health care services must be:
The NRHA will work to further develop and implement A National Agenda for Rural Minority Health. Due to the President's Initiative on Race and the national mandate to eliminate health disparities by 2010 in six areas of health among racial and ethnic minority populations, the NRHA believes that now and into the coming 21st century, the time is appropriate to move this agenda forward. Clearly, with such a mandate for change and a national policy issue acting as a guiding force for the nation, A National Agenda for Rural Minority Health that begins to address the question of "how" is an important component in meeting the goal of "One America in the 21st Century."
In August 1998, the NRHA's Rural Minority Health Committee identified health professions as a fourth priority area to be addressed. To more effectively detail A National Agenda for Rural Minority Health, a series of four issue papers focusing on each of the four priority areas of the agenda will be written in the future. These papers are: