The 2009 TFAH report on public health protection and bioterrorism preparedness

2009 TFAH report, Ready or Not? Protecting the Public's Health from Diseases, Disasters and Bioterrorism

The issue of funding healthcare initiatives for state residents living in rural areas is certainly important and often overlooked. According to the Rural Assistance Center (RAC), which tracks public healthcare assistance and access for this historically underserved population, slightly less than half of all of the state of Alabama's hospitals are in rural areas and federally qualified health centers also exist to provide services at 151 sites in rural locations. This suggests that proximity to healthcare facilities is less of an issue than it may be in other states (Alabama, 2010, RAC). However, the challenges of poverty still afflict Alabama residents. While the average per-capita income for all Alabama residents in 2007 was $32,419, the average rural per-capita income of a state resident was $27,754 (Alabama, 2010, RAC). 18.6% of residents in rural Alabama live below the poverty line compared with 14.8% of urban residents of the state (Alabama, 2010, RAC).

Education is also another important aspect of healthcare, given that health literacy is a vital component of public health improvement. Only with access to information will individuals take real, proactive steps to improve their lifestyles and seek appropriate preventative screening. But individuals may not have the appropriate educational background to understand health-related concepts and materials. And individuals from rural backgrounds are less likely to have an education in Alabama: 30.7% of the rural population does not have a high school diploma, versus 22.2% of individuals in urban locations. Finally, the unemployment rate in rural Alabama is 6.0% versus urban Alabama where it is 4.7%. 14.0% of Alabama residents lack health insurance of any kind (Kaiser, 2008-2009).