Drs. Nathan Hale and Kate Beatty, assistant professors in the Department of Health Services Management and Policy in the East Tennessee State University College of Public Health, have authored an article in the American Journal of Preventive Medicine. The article, “Local Health Departments as Clinical Safety Net in Rural Communities,” examines the differences in clinical service provision among rural and urban local health departments for early periodic screening, diagnosis, and treatment (EPSDT) and prenatal care services. Dr. Tamar Klaiman, of the University of the Sciences, Philadelphia, Pennsylvania, and Mr. Michael Meit, of NORC at the University of Chicago, Chicago, Illinois are also authors.
Dr. Hale, lead author, comments, “This research really underscores how challenging it can be for rural communities—particularly those in economically vulnerable parts of the country—to ensure access to basic preventive clinical health services for women and children.”
The study team reviewed data collected from the 2013 National Association of County and City Health Officials Profile of Local Health Departments. They discovered approximately 35 percent of local health departments in the analysis provided early periodic screening, diagnosis, and treatment services directly and 26 percent provided prenatal care. In communities where there were no other providers for these services, local health departments were four times more likely to report providing these services directly and six times more likely to provide prenatal care services directly. The presence of a Federally Qualified Health Center in the county was associated with reduced clinical service provision by local health departments.
Dr. Hale states, “Many local health departments remain important provider of these services, more so than what we see in more urban communities.”
The study found evidence that many local health departments in rural communities provide clinical services and are critical components of the healthcare safety net. The unique position of rural local health departments should be considered in national policy discussions around the organization and delivery of public health services, particularly as they relate to clinical services.
Dr. Hale concludes, “Often we assume there are other providers in communities who can provide these services, but that’s not always the case. In many communities the local health department is the primary source of care for many women and children.”