title: Rural public health policy models to address an evolving environmental asbestos disaster.
abstract: The health-related dangers of asbestos exposure were recognized early in the 20th century when occupational exposure was found to be associated with excess pneumoconiosis among asbestos industry workers. Today, the epicenter for examining the public health effects and the human toll that this toxin has had on a population is located in the rural community of Libby, MT. Rurality and multideterminants of health frame both the history of asbestos-related disease and the service/policy challenges within a community dealing with chronic illness and designation as a Superfund clean-up site. Despite efforts by public health advocates to address the lingering aftermath of an environmental disaster in this community, policy gaps exist that continue to impact the population's health. The purpose of this paper is to describe the history and outcomes of asbestos exposure in a rural community and discuss 3 models that provide public health policy insights related to rural health and health care for a community affected by both a sentinel and ongoing environmental event.
authors.affiliation: College of Nursing, Montana State University, Missoula Campus, Missoula, MT 59812-7416. skuntz@montana.edu
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Kuntz
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Winters
authors.forename: Wade G
authors.initials: WG
authors.lastname: Hill
authors.forename: Clarann
authors.initials: C
authors.lastname: Weinert
authors.forename: Kimberly
authors.initials: K
authors.lastname: Rowse
authors.forename: Tanis
authors.initials: T
authors.lastname: Hernandez
authors.forename: Brad
authors.initials: B
authors.lastname: Black
mesh_terms: D001194:Asbestos / Q000009:adverse effects*; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D008962:Models, Theoretical; D009009:Montana; D016273:Occupational Exposure / Q000517:prevention & control*; D011634:Public Health; D011637:Public Health Nursing; D012424:Rural Population
chemical_list: D001194:Asbestos