Abstract
The past year has highlighted an increased concern for effective health care delivery and improved consumer health education. Encompassing both areas are the problems of health manpower shortage and, of great urgency to the future of rural health, the problems of distribution. If workable solutions are to be provided, the inadequacies of the interwoven social, economic, and health care delivery systems must be dealt with. To illustrate, I tell the story of Rappahannock County, Virginia, which received publicity recently because it was facing a critical health shortage. The third county in Virginia to lose its last physician, it had been inadequately served for at least three years. Efforts to provide these services had gotten nowhere, and physicians in nearby counties were already laboring under heavy caseloads. The dental care situation was no less severe—the local public health nurse reported that the county has had no dentist for at least two
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