It has been the purpose of this study to determine the medical care needs among rural Pulaski County folks in relation to tenure, land class, and occupations which are indicative of income, age and sex, schooling of the homemaking, size of family or household, distance from medical personnel and facilities, and loss of income through absenteeism from wrong because of illness. The expenditures for six types of medical care and health insurance were also studied in relation to the factors above. / M.S.

In this study, county level data for three time periods (1970, 1985, and 1989) are examined to determine the factors affecting the distribution of primary care physicians in rural counties of Virginia. Consistent predictors of proportions of physicians to the population were identified: golf holes per capita and the ratio of hospital beds to population were the most consistent predictors. Per capita income and the elderly population were only significant for some of the years. Variables deemed to be controllable by the community (in the short run) were generally more consistent in predicting the proportions of physicians to population. Policy implications are discussed, and several strategies for improving access to health care in rural areas, thus altering the massive imbalance in physician to population ratio in urban and rural areas are suggested. / Master of Science

National health care reform proposals advocate Primary Health Care (PHC) and preventive medicine as an efficacious way to control health care costs in the United States. This study examined a community in rural, southwest Virginia and evaluated the potential for PHC success. The study used focus groups to determine how Women Users, as consumers of health care, view their health and health care problems and potential solutions. Views of Community Leaders and Service Providers, as controllers of services, were obtained using semi-structured interviews. The results were compared using the PRECEDE framework of predisposing, enabling, and reinforcing factors influencing health behavior. This study was a component of a larger project - The Dickenson County Women's Health Project. The premise of that project was that women in Dickenson County would respond to a health education intervention program and the goal was to develop such a program. This study shows that Women Users fully comprehend the health behaviors and available services that would make themselves more healthy, but feel constrained by enabling and reinforcing factors that prevent healthy lifestyles. By contrast, Service Providers and Community Leaders focus on predisposing factors and remain convinced that women in Dickenson County need more education about healthy lifestyles and available health services. The study concludes that the women of Dickenson County are valuable resources for health program development. The success of PHC in Dickenson County is wholly dependent upon developing a mechanism whereby women are given a greater voice in program development and implementation. / Master of Urban Affairs