1. SUS Rural Pediatrics by David Keller reviewed by John Walburn Tom Tonniges SUS

2. SUS What is Rural America?? Census: rural areas are located outside urbanized areas with population no greater than 2500 Only 28% of Americans live in rural areas

3. SUS Serving the Underserved: Urban vs. Rural Common Assets –Family –Community institutions Common Barriers –Poverty –Lack of providers –Transportation –Inadequate agency resources Rural Assets –Land. –Food Rural Barriers –Seasonal labor –Lack of sub- specialists –Distance –Inadequate agencies

4. SUS Provider Availability by Population Densit

5. SUS Federal Efforts to Improve Rural Health Care Hill-Burton Act Community/ Migrant Health Centers National Health Service Corps

6. SUS Pediatricians in Rural America: 1981-1996 From Randolph GD. Pathman DE. Trends in the rural-urban distribution of general pediatricians. Pediatrics. 107(2):E18, 2001 Feb.

7. SUS Rural Counties without Pediatricians: 1996 From Randolph GD. Pathman DE. Trends in the rural-urban distribution of general pediatricians. Pediatrics. 107(2):E18, 2001 Feb.

8. SUS Formulate a Problem List Traditional Problem List –Problems by System Extended Problem List –Transportation –Health insurance –Social Services –Educational services

9. SUS Formulate a Problem List Problem List –Down syndrome –Heart murmur –IDDM –Developmental delay Extended Problem List –Transportation –Health insurance –Lack of specialists –Inadequate educational services

10. SUS Skills for Rural Pediatrics Community Assessment: –What is available out there? –What do we need to build? Collaboration: –Finding the time –Putting together the team.