Is Rural Emergency Medicine a Concept Beyond Definition?
Jonna Gies, MD Just as the name implies, rural emergency medicine is the practice of emergency medicine in a rural area. The challenge lies in defining rurality. According to Whitaker (1982), “rural” was first used by the U.S. Bureau of the Census in 1874 when it was defined as the population of a county exclusive of any cities or towns with 8,000 or more inhabitants. Modified over the years, by the 1980 census, a specific definition for rural had been dropped. Instead, the urban population is now defined as all persons living in urbanized areas and places of 2,500 or more located outside urbanized areas; all population not classified as urban constitutes the rural population (U.S. Bureau of the Census, 1983). One way to define rural is by determining what it is not. The Office of Management and the Budget defines metropolitan statistical areas (MSAs) as geographic areas consisting of a large population nucleus, and economically and socially related adjacent communities. Remaining area
