Perspectives on cancer health disparities in West Virginia.

"Perspectives on Cancer Health Disparities in West Virginia" provides an overview of the factors that lead to health disparities in general, to the burden of breast and other cancers in our state, and highlights the deep-rooted values and characteristics that will help communities and their partners achieve parity.

Research on rural veterans: an analysis of the literature.

CONTEXT: The Veterans Health Administration (VA) provides comprehensive health care services to veterans across the United States. Recently, the VA established an Office of Rural Health to address the health care needs of rural veterans. PURPOSE: To review the literature on rural veterans' health care needs in order to identify areas for future research. METHODS: We conducted a literature review of articles listed in the Medline, CINAHL, and BIOSIS datasets since 1950. We reviewed and summarized the findings of 50 articles that specifically examined rural veterans. FINDINGS: The literature on rural veterans included 4 articles examining access to care, 7 evaluating distance technology, 4 examining new models of care delivery, 11 studying rural veterans' patient characteristics, 10 evaluating programs provided in a rural setting, 6 examining rural health care settings, and 8 exploring rural veterans' health services utilization patterns. Most studies were small, based on data obtained before 2000, and consisted of uncontrolled, retrospective, descriptive studies of health care provided in rural VA settings. Definitions of rural were inconsistent, and in 20% of the articles examined the rural aspect of the setting was incidental to the study. CONCLUSIONS: The literature on rural veterans' health care needs warrants expansion and investment so that policy makers can make informed decisions in an environment of limited resources and competing interests.

Oral health disparities in Appalachia: orthodontic treatment need and demand.

BACKGROUND: Significant oral health disparities affect people in West Virginia and elsewhere in Appalachia. Although oral diseases such as caries are a major problem, little is known about the occlusal status of this under-served group. METHODS: Fifty-eight adolescents (ages 12-17 years) and 78 of their parents underwent an orthodontic examination as part of a larger study on oral health in two rural West Virginia counties. Two orthodontists used a standardized index to rate their need for orthodontic care. Participants were interviewed regarding their demand for and history of orthodontic care. RESULTS: The study results show that parents had a high rate of complete or partial edentulism, an infrequent history of orthodontic treatment, great unmet orthodontic need and less demand for orthodontic care than was suggested by their clinically determined need. The adolescents were similar to national norms with regard to orthodontic treatment history and need, but lower with regard to demand. CONCLUSIONS: The adolescents' similarity to general population norms with regard to previous orthodontic care and level of occlusal status is promising. Nevertheless, their lower recognition of a need for treatment suggests possible future oral health problems and a lower oral health quality of life. Their parents, however, were considerably worse off, in comparison with their adolescent children and adult comparison samples, with regard to orthodontic care and other oral health status measures. CLINICAL IMPLICATIONS: Culturally sensitive psychoeducational methods to promote recognition of oral health needs may be required among adolescents in Appalachia to have an impact on oral health values and to prevent oral health problems. Issues of orthodontic care utilization and, perhaps, access to care need to be addressed among adults in Appalachia.

Rural healthcare: how to recruit and retain health professionals.

A major challenge for healthcare in the United States is recruiting and retaining health professionals in rural areas of the country. There is a significant shortage of physicians and other health professionals in many of these areas. This article outlines some of the factors that go into recruiting health professionals to practice in rural communities, and what factors are influential in making sure they remain in service to those communities.