title: Medical Education to Improve Rural Population Health: A Chain of Evidence From Alabama.
abstract: OBJECTIVE
  To provide evidence that medical education is associated with population health in order to support adaptation of medical school programs to address populations with health disparities. We explored medical education efforts, local physician supply, and life expectancy in Alabama.
  
  
  METHODS
  County-level public data of the number of students accepted to medical schools in 2008 and 2011, primary care physicians, life expectancy, and demographic/contextual variables were analyzed to develop a model for hypothesized associations. Correlational analysis, ANCOVA modeling, and path analysis were employed to identify, reduce, and organize significant variables in this cross-sectional ecologic study.
  
  
  RESULTS
  The path model, which met criteria for goodness of fit, found significant relationships among medical students per 10,000 population, primary care physicians per 10,000 population, life expectancy, and contextual variables for rurality and poverty. ANCOVA models showed that geographic region was significant.
  
  
  CONCLUSIONS
  Within limitations of the study design, these findings support the proposition that the number of medical students produced in a county is related to the number of primary care physicians, which is related to life expectancy. Recommendations are to confirm the findings in other populations and inform public health policy concerning the utility of medical education to address population health by producing local medical students.
authors: Department of Community and Rural Medicine, College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama.
authors: John R
authors: JR
authors: Wheat
authors: College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama.
authors: Veronica L
authors: VL
authors: Coleman
authors: Department of Psychology, The University of Alabama, Tuscaloosa, Alabama.
authors: Shannon
authors: S
authors: Murphy
authors: Rural Medical Scholars Program, University of Alabama School of Medicine-Tuscaloosa, Tuscaloosa, Alabama.
authors: Caleb M
authors: CM
authors: Turberville
authors: Department of Community and Rural Medicine, College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama.
authors: James D
authors: JD
authors: Leeper
mesh_terms: D000407:Alabama; D057191:Capacity Building; D004501:Education, Medical / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008507:Medically Underserved Area; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D019035:Rural Health Services; D012424:Rural Population / Q000706:statistics & numerical data*; D012577:Schools, Medical; D000078329:Workforce
keywords: evidence-based research; medical education; physician supply; policy; population health