March, 2006 - Roughly one-half of all local public health departments in the United States are both small and rural. Sixty percent of local health departments that responded to a survey in 2000 said they were located in a non-metropolitan area, the designation for “rural” developed by the Office of Management and Budget and used for policy purposes by agencies such as the Center for Medicare and Medicaid Services.
Forty-eight percent of local public health departments were categorized as “rural” in 2002 using a more refined definition, Rural-Urban Commuting Area Codes. One-half of local health departments responding to the 2000 survey served populations
of fewer than 25,000 people, and 69 percent served populations of fewer than 50,000 people.