A new look at an old hat

In this issue of The Journal (p 2647), Kane discusses an age-old problem—”Rural Health Care: Medical Issues.” Even among the eldest of us, this saga of the problems of rural America is old hat. Kane gives us a fresh look at this long-lasting problem. It becomes obvious to one who has reviewed the statistical data that the definition of “rural” needs to be elucidated. Villages of fewer than 2,500 people may qualify to be termed rural for statistical analyses, but many such villages often are affluent appendages to urban or suburban areas. Kane points out the misleading statistic that Pennsylvania is the most rural state in America, and he further shows that the rurality of Pennsylvania or North Carolina is, indeed, different from that of Wyoming or Montana. Perhaps when the word “rural” is used in studies, surveys, or any statistical compendium, there should be adherence to uniform, well-defined criteria