OPEN: Strengthening Rural States’ Capacity to Prepare for and Respond to Emerging Infectious Diseases, 2013–2015

Authors: Scott Santibañez, MD, MPHTM, Kimberly Spencer Bellis, MPH, Allison Bay, MPH, Christina L. Chung, MPH, Kristy Bradley, DVM, MPH, Deborah Gibson, MPH, MT, Alvin Shultz, MPH


Because clinicians may be the first to encounter cases of emerging infectious diseases, they need to be able to work together with public health departments to quickly identify and respond to infectious disease outbreaks. Infectious diseases are a constant threat in many parts of the United States, including rural areas. For example, from 2004 to 2016 reports of diseases from mosquito, tick, and flea bites—which are known to affect rural areas—have tripled in the United States.1
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Table. 14 US states with high percentages of people living in rural areas, 2010 US Census Bureau2

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Fig. Frequency of self-reported disease-specific public health activities in 14 rural states, funded by the Epidemiology and Laboratory Capacity (ELC) cooperative agreement, United States, 2013–2015.

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1. Rosenberg R, Lindsey NP, Fischer M, et al. Vital signs: trends in reported vectorborne disease cases-United States and territories, 2004-2016. MMWR Morb Mortal Wkly Rep 2018;67:496-501.
2. US Census Bureau. 2010 census urban and rural classification and urban area criteria. Accessed June 6, 2017.
3. Meit M, Harris K, Bushar J, et al. Challenges, opportunities, and strategies for rural public health agencies seeking accreditation. Published June 2008. Accessed November 30, 2018.
4. Moy E, Garcia MC, Bastian B, et al. Leading causes of death in nonmetropolitan and metropolitan areas-United States, 1999-2014. MMWR Surveill Summ 2017;66:1-8.
5. Garcia MC, Faul M, Massetti G, et al. Reducing potentially excess deaths from the five leading causes of death in the rural United States. MMWR Surveill Summ 2017;66:1-7.
6. National Association of County and City Health Officials. 2016 national profile of local health departments. Accessed May 22, 2017.
7. DeCuir-Gunby JT, Marshall PL, McCulloch AW. Developing and using a codebook for the analysis of interview data: an example from a professional development research project. Field Methods 2011;23:136-155.
8. Chung C, Fischer LS, OʼConnor A, et al. CDC's "flexible" epidemiologist: a strategy for enhancing health department infectious disease epidemiology capacity. J Public Health Manag Pract 2017;23:295-301.
9. National Park Service. Yellowstone National Park visitation statistics. Accessed November 30, 2018.
10. CDC. La Crosse Encephalitis. Accessed December 14, 2018.