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November 22, 1985

Improving Rural Health: Initiatives of an Academic Medical Center

Author Affiliations

The University of North Carolina at Chapel Hill School of Medicine

JAMA. 1985;254(20):2973. doi:10.1001/jama.1985.03360200127048

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During most of the 1970s, rural health, especially the rural physician shortage, was on nearly everyone's "top ten" list of health care issues. (It has since slipped from that position, owing to cutbacks in discretionary federal domestic expenditures, a ballooning of the total physician supply, and replacement of resource distribution by cost control as most favored public policy target.)

The early part of the decade saw several new rural health related actions—Congress established the National Health Service Corps; the Public Health Service placed a rural priority on its community health services project grants (the "Rural Health Initiative"); several midwestern and southern states opened new "regional" medical schools in areas thought to be generally underserved; a few medical schools organized "area health education centers"; two major philanthropic foundations announced national programs in rural health; and postgraduate training in the new specialty of family medicine came of age. Perhaps less widely known