Ch 24: Rural and Migrant Health
Which of the following best explains why the rural population is growing when young persons from rural
areas consistently are moving to urban areas to seek employment?
a. Adults engaged in all the physically demanding farming tasks have longer life spans than people in
urban areas.
b. Farm families continue to have a higher birth rate than urban families.
c. Many formerly migrant worker Hispanics are settling in rural counties.
d. Retirees and other urbanites able to conduct business through telecommunication and travel are
moving in. - correct answer ✔✔ANS: D
Recent demographic changes in rural areas have also included an influx of retirees and others from
urban areas who are able to live in rural areas and conduct business through telecommunication and
travel. The other responses do not support the current reason for the increase in the rural population.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 445
Which of the following best explains why there are so few hospitals in rural areas?
a. Few nurses and physicians enjoy the rural lifestyle.
b. Historically, hospitals began in large urban areas and have slowly expanded outward but have not yet
reached all rural areas.
c. Rural areas have very low population density.
d. Rural residents do not trust hospitals, preferring to receive care from neighbors and friends. - correct
answer ✔✔ANS: C
Although 75% of U.S. counties are classified as rural, they contain only 20% of the U.S. population. The
population density is too low to support a large hospital. There are providers available to serve the
population and residents are accepting of health care services, but not as many services are needed
because of the lower population density.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 446
,From which of the following causes are rural residents twice as likely to die from in comparison with
urban residents?
a. Chronic diseases, especially cardiac problems and cancers
b. Diabetes from the higher incidence of obesity
c. Respiratory diseases (from pesticides and herbicides)
d. Unintentional injuries - correct answer ✔✔ANS: D
Residents of rural areas are nearly twice as likely to die of unintentional injuries, including motor vehicle
accidents, when compared with their urban counterparts. The rates of chronic diseases, diabetes, and
respiratory diseases are more similar to that of urban residents.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 446
Which of the following factors would cause a geographic area to be called a frontier area?
a. Arbitrary distinction recognizing the Great Plains, Intermountain areas, and Alaska
b. Geographically located in the West, specifically the Great Plains states
c. High death rate from use of guns (homicide or suicide)
d. Population of fewer than six persons per square mile - correct answer ✔✔ANS: D
Areas are classified as rural for populations with fewer than 45 persons per square mile and as frontier
for geographic areas with fewer than six people per square mile. Many counties of the Great Plains,
Intermountain West, and Alaska are designated frontier. Not all mountain areas are rural (the
Appalachian mountain area is not), and geographic location alone does not make an area rural.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 446
Which of the following best describes the practical importance of the classifications of metropolitan,
micropolitan, and noncare areas?
a. Classifications are used for congressional policy-making and funding decisions.
b. Metropolitan areas gained importance because of their large population.
c. Micropolitan areas are now recognized for their crucial role in society.
d. The new system emphasizes the extent of rural (noncare) areas.
, @ANS: A
The new core-based statistical areas (CBSA) system includes two categories of counties: (1) metropolitan
areas and (2) micropolitan areas. Counties that are neither metropolitan nor micropolitan are called
"outside CBSAs," also known as noncare areas. Metropolitan areas contain at least one urbanized area of
50,000 or more people. A micropolitan area contains a cluster of 10,000 to 50,000 persons. Because the
metropolitan statistical area classification is used extensively for congressional policy-making and
funding decisions, there could be serious ramifications for health care financing within rural market
areas.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 446
Which of the following compositional factors influences rural health needs?
a. Demographics of the people living in an area
b. Local environment
c. The geography of the area
d. The political and social institutions in the community - correct answer ✔✔ANS: A
There is a growing emphasis on the distinction between context, which is defined by the characteristics
of places of residence, and composition, which is the collective health effects that result from a
concentration of persons with certain characteristics. Problems in rural areas are compositional when
they derive from individual characteristics of groups of people residing in rural settings. Examples of
compositional sources of health disparities include such characteristics as age, education, income,
ethnicity, and health behaviors. The environment, geography, and political and social institutions are
considered to be characteristics of place.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 447
Which of the following describes what has been identified by public health experts as the number one
priority in rural areas?
a. Access to health care
b. Access to education
c. Access to telecommunications
d. Access to better-paying employment opportunities - correct answer ✔✔ANS: A
Which of the following best explains why the rural population is growing when young persons from rural
areas consistently are moving to urban areas to seek employment?
a. Adults engaged in all the physically demanding farming tasks have longer life spans than people in
urban areas.
b. Farm families continue to have a higher birth rate than urban families.
c. Many formerly migrant worker Hispanics are settling in rural counties.
d. Retirees and other urbanites able to conduct business through telecommunication and travel are
moving in. - correct answer ✔✔ANS: D
Recent demographic changes in rural areas have also included an influx of retirees and others from
urban areas who are able to live in rural areas and conduct business through telecommunication and
travel. The other responses do not support the current reason for the increase in the rural population.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 445
Which of the following best explains why there are so few hospitals in rural areas?
a. Few nurses and physicians enjoy the rural lifestyle.
b. Historically, hospitals began in large urban areas and have slowly expanded outward but have not yet
reached all rural areas.
c. Rural areas have very low population density.
d. Rural residents do not trust hospitals, preferring to receive care from neighbors and friends. - correct
answer ✔✔ANS: C
Although 75% of U.S. counties are classified as rural, they contain only 20% of the U.S. population. The
population density is too low to support a large hospital. There are providers available to serve the
population and residents are accepting of health care services, but not as many services are needed
because of the lower population density.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 446
,From which of the following causes are rural residents twice as likely to die from in comparison with
urban residents?
a. Chronic diseases, especially cardiac problems and cancers
b. Diabetes from the higher incidence of obesity
c. Respiratory diseases (from pesticides and herbicides)
d. Unintentional injuries - correct answer ✔✔ANS: D
Residents of rural areas are nearly twice as likely to die of unintentional injuries, including motor vehicle
accidents, when compared with their urban counterparts. The rates of chronic diseases, diabetes, and
respiratory diseases are more similar to that of urban residents.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 446
Which of the following factors would cause a geographic area to be called a frontier area?
a. Arbitrary distinction recognizing the Great Plains, Intermountain areas, and Alaska
b. Geographically located in the West, specifically the Great Plains states
c. High death rate from use of guns (homicide or suicide)
d. Population of fewer than six persons per square mile - correct answer ✔✔ANS: D
Areas are classified as rural for populations with fewer than 45 persons per square mile and as frontier
for geographic areas with fewer than six people per square mile. Many counties of the Great Plains,
Intermountain West, and Alaska are designated frontier. Not all mountain areas are rural (the
Appalachian mountain area is not), and geographic location alone does not make an area rural.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 446
Which of the following best describes the practical importance of the classifications of metropolitan,
micropolitan, and noncare areas?
a. Classifications are used for congressional policy-making and funding decisions.
b. Metropolitan areas gained importance because of their large population.
c. Micropolitan areas are now recognized for their crucial role in society.
d. The new system emphasizes the extent of rural (noncare) areas.
, @ANS: A
The new core-based statistical areas (CBSA) system includes two categories of counties: (1) metropolitan
areas and (2) micropolitan areas. Counties that are neither metropolitan nor micropolitan are called
"outside CBSAs," also known as noncare areas. Metropolitan areas contain at least one urbanized area of
50,000 or more people. A micropolitan area contains a cluster of 10,000 to 50,000 persons. Because the
metropolitan statistical area classification is used extensively for congressional policy-making and
funding decisions, there could be serious ramifications for health care financing within rural market
areas.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 446
Which of the following compositional factors influences rural health needs?
a. Demographics of the people living in an area
b. Local environment
c. The geography of the area
d. The political and social institutions in the community - correct answer ✔✔ANS: A
There is a growing emphasis on the distinction between context, which is defined by the characteristics
of places of residence, and composition, which is the collective health effects that result from a
concentration of persons with certain characteristics. Problems in rural areas are compositional when
they derive from individual characteristics of groups of people residing in rural settings. Examples of
compositional sources of health disparities include such characteristics as age, education, income,
ethnicity, and health behaviors. The environment, geography, and political and social institutions are
considered to be characteristics of place.
DIF: Cognitive Level: Remember (Knowledge) REF: p. 447
Which of the following describes what has been identified by public health experts as the number one
priority in rural areas?
a. Access to health care
b. Access to education
c. Access to telecommunications
d. Access to better-paying employment opportunities - correct answer ✔✔ANS: A
