Regarding Objective B-4 in the Access chapter, the proposed new definitions on shortage designations by the Bureau of Primary Care may mask problems because they change the definition of what is a shortage area. Need oversampling of rural and frontier populations in health surveys. Need to examine both crude and adjusted rates for health conditions when looking at RF populations. It has a very young population and many people have risky lifestyles. There are no local health departments.
Major issues are transportation and getting services to people.
We need something more achievable for HP 2010 objectives. Question how the leading health indicators were chosen since some are not relevant for rural and frontier areas. Need to ensure that national objectives are relevant to policy and individual action in rural and frontier areas. It is difficult to apply national goals in rural and frontier areas because many are not relevant. Need for priorities based on specific and local populations not national populations.