Rural-urban differences in the public health workforce: local health departments in 3 rural Western states.

✖ Rural LHDs are very small, with fewer than 5 working professionals in the average office, compared with nearly 32 in an average urban office. ✖ The per capita public health workforce supply is slightly greater in rural than in urban LHDs (32:100,000 versus 29:100,000). ✖ Public health nurses form the core of rural LHDs; urban LHDs have a wider variety of professional categories represented within their walls. ✖ The spectrum of public health services delivered is narrower in rural LHDs than in urban ones. ✖ A large portion of rural public health personnel (with the exception of Alaska) work part time, and many lack formal public health training. ✖ Vacant rural LHD positions are relatively infrequent.