We examined changes in the scope of activity and organizational composition of public health delivery systems serving rural and urban U.S. communities between 2014 and 2018. Urban public health systems enhanced their scope of activities and organizational networks since 2014, while rural systems lost capacity. These trends suggest that system improvement initiatives have had uneven success, and they may contribute to growing rural-urban disparities in population health status.
Systems for Action Intramural Team:
- Kelsey Owsley, MPH
- Glen Mays, PhD