Alva Ferdinand, DrPH, JD

Alva O. Ferdinand, DrPh, JD is an associate professor and head of the Department of Health Policy and Management at the Texas A&M University School of Public Health. She is also the Director of the Southwest Rural Health Research Center.

Ferdinand has been a leader of the American Public Health Association’s law section since 2016 and was an integral part of the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Population Health Improvement in 2020. She is also a member of the Ethics Advisory Committee for the University of Nebraska Medical Center and of the Rural Health Panel of the Rural Population Policy Research Institute (RUPRI) at the University of Iowa.

Since 2016, her research activities have been funded by the Federal Office of Rural Health Policy (FORHP) within the U.S. Department of Health and Human Services (HHS), the Patient-Centered Outcomes Research Institute (PCORI) and the Episcopal Health Foundation, among others. Ferdinand has examined variations in the burden of chronic diseases across the urban-rural continuum, including cancer and diabetes. She has additionally examined the association of tax-exemption status on the provision of community benefits among various hospital ownership types. Moreover, she has provided legislative testimony and briefings to policymakers at state and federal levels and continues to inform policy strategies, particularly as they relate to rural populations.

In 2014, Ferdinand received the Academy Health Outstanding Dissertation Award for her examination of the effect of texting-while-driving bans on various subpopulations of the U.S. Ferdinand holds a law degree from the Michigan State University College of Law and a Doctor of Public Health degree from the University of Alabama at Birmingham.

Title

Charting a Course for Rural Health Over the Next Decade: Leading Causes of Death and Priority Healthy People 2030 Objectives 

Abstract

Rural populations in Texas and the rest of the U.S. live in unique circumstances that directly impact opportunities for health and wellness. Some of these circumstances include residing far away from primary and specialty care, grocery stores and farmers’ markets, and incomes that are heavily dependent on favorable weather conditions (e.g. income generated from farming and ranching). 

Researchers affiliated with the Southwest Rural Health Research Center (SRHRC) at Texas A&M University have recently conducted work to examine the current evidence base for the five leading causes of death (heart disease, cancer, unintentional injuries, chronic lower respiratory diseases, and stroke) as it relates to rural residents and racial/ethnic minorities in Texas and in the U.S. more broadly. A scoping review methodology was applied to identify all articles that explored the relationship between both rurality and race/ethnicity and the five leading causes of death in two separate studies of the literature that used samples from Texas and from the U.S. in general. Across the two studies, over 660 articles were reviewed. Cancer was by far the most studied leading cause of death in Texas-based and nationally representative studies that factored in associations of rurality and race/ethnicity. Few studies (9% - 16% of all studies) examining unintentional injuries, chronic lower respiratory disease, stroke, and heart disease took race/ethnicity and rurality into account in their analyses. 

In another SRHRC study, rural stakeholders were asked to think about the goals set by the U.S. Department of Health and Human Services (HHS) in Healthy People 2030, and what the priorities should be for rural America. Similar surveys of rural stakeholders were conducted by the SRHRC based on Healthy People 2010 and Healthy People 2020. For the first time in 3 decades, a greater proportion of respondents identified “Mental Health and Mental Disorders” and “Addiction” as Healthy People priorities for rural America than “Health Care Access and Quality.” “Economic Stability,” a new priority within the Social Determinants of Health category, debuted within the 10 most frequently selected priorities for rural America for this decade. 

As public health practitioners, researchers, clinicians, and policymakers work toward narrowing the urban-rural divide, the evidence base tied to the leading causes of death in rural and minority contexts should be strengthened. Further, given resource constraints in rural America, top-ranked issues should as mental health and substance use disorders, as well as social determinants of health like economic stability should be robustly focused on in the upcoming decade. 

Page last updated 2:42 PM, January 30, 2024