Residents of rural communities have poorer health status than people living in more populated areas. For example, The Urban and Rural Health Chartbook notes that the age-adjusted death rate among younger (1-24 years of age) persons who live in the most rural counties is 31 percent higher than those who live in the most urban counties and 65 percent higher for those who live in suburban counties (Eberhardt, Ingram, Makuc et al., 2001). Explanation for the health disparity experienced by rural residents is complex due to the influence of both community factors and the socioeconomic and behavior patterns of individuals. Access to health care, including preventive care, as well as substantial challenges with health literacy, higher instances of smoking, and lack of health insurance among rural residents, are some of the main causes of this disparity.

Rural health care providers must cope with various challenges that far exceed recognized, conventional concerns such as financing, controlling costs, and ensuring proper medical care. The provision of health care in rural populations is additionally complicated by limited number of health care providers, higher rates of uninsured, longer distances to travel for treatment, and fewer community resources to supply and support health care (Bierman and Clancy, 1999; Keefover et al., 1996; Noonan, 1997; Aadalen, 1998; Moscovice and Rosenblatt, 2000; Dalton, 2001; Welch et al., 2002; Beaulieu et al., 2003). In order to address rural access problems, federal and state health agencies have implemented a variety of programs, including Federally Qualified Health Centers (FQHCs), Critical Access Hospitals (CAHs), Rural Assistance Center (RAC), Rural Health Clinics (RHCs), and state sponsored Rural Development Councils (Kozma, 1998; Diamond, 1999; Rawlings-Sekunda et al., 2001 June; Welch et al., 2002; Foote, 2003). Despite the intent of these programs to provide and improve health care in rural locations, limited access to health care by rural populations continues as a significant concern.