In 1996, I was born to two Filipino immigrants in El Paso, Texas. At the time, my father was in the process of completing his residency at the University of Texas, working strenuous 16-hour days almost every day as a fledgling resident physician. My mother was a full-time nurse then, working nightshifts to give her the freedom to tend to me during the day while my father was in training. Prior to their immigration to the United States under working visas in 1994, both of my parents came from families whose livelihood depended on agriculture. For my father, it was fishing, raising livestock, and tending to rice fields in a village called Siaton; for my mother, it was sugar cane processing and a family business of selling pigs in a town called Bogo. Despite facing many ups and downs along the way, these family occupations afforded my parents the opportunity to attend school from elementary to higher education. They eventually decided to pursue jobs in the health care industry so that they could immigrate to the United States, send money back to their loved ones in the Philippines, and provide a better life for the family they intended to start together.

Due to unique barriers to access and quality of healthcare, rural Americans have, among many other poorer health outcomes, a worsening life expectancy than their urban counterparts: 76.8 years compared to 78.8 years. In addition to overall mortality, the burden of disease is greater in rural areas, as well as rates of physical injury. There are many intersecting influencing factors including, but not limited to, barriers to access needed healthcare, issues regarding the quality of healthcare provided, the ability to pay for healthcare and other socioeconomic considerations are both causes and consequences of poor health and healthcare access.
The health disparities between rural and urban communities in the United States are not uniquely American. This rural-urban divide in health outcomes is present across the world and, closer to home, across North America. In addition to reviewing the current literature surrounding barriers to health and healthcare access in the United States, we will also use southern neighbor Mexico’s history and their pursuit of rural equity (universally and in health/healthcare access) to contrast initiatives that the U.S. has attempted, with the intent of exploring new theories of rural healthcare provision. By combining the history of social medicine in Mexico with literature on barriers to healthcare access, I hope to highlight areas of innovation and improvement in the American health care delivery system.
The purpose of this paper is to review the current literature regarding health disparities among rural Americans, possible causes of such disparities and current strategies to improve health, healthcare access and healthcare quality in rural America in order to recommend the most effective, practical solutions to improve rural mortality, morbidity and quality of life.

Objective: To explain the origins of the pediatric asthma cluster present in south and central phoenix, and propose potential solutions to combat this cluster. Methods: A comprehensive literature review of the different factors that contribute to asthma starting at a national level and working down to the Maricopa county level was conducted. Afterwards a literature review of past pediatric asthma intervention case studies was conducted. The results of both literature reviews were synthesized in regards to applicability in south and central phoenix. Results: A combined targeted intervention in health care delivery, patient/clinician education, and housing status/infrastructure could yield promising results in regards to combatting the pediatric asthma cluster in south and central phoenix.

This paper addresses policy solutions for the continuing medical education of providers treating LGBTQ patients. As a population subject to significant health disparities, LGBTQ individuals are at risk of discrimination and harm when entering the medical context and, as such, require particular provider competence in approaches to care. This population is also vulnerable to distinctive medical needs which often position individuals as patients, making clinical interactions a key component of equality in social contexts. Through literature review and policy analysis, this paper addresses how systemic inequality has been propagated in the medical community and suggests an intervention in developing critical CME materials and requirements which seek to promote provider knowledge of best practices for the treatment of LGBTQ individuals. The ultimate policy suggestion incorporates existing policy promulgated at the state and professional organization level to fully respond to the challenges of informing providers of best practice in a meaningful, practicable manner. This policy specifies the importance of mandatory content-based learning hour requirements, in order to ensure that all providers meet a minimum level of competency in providing care to minority and at-risk populations, particularly the LGBTQ population. Moreover, it encompasses an understanding of the role and importance of outside organizations with subject-area expertise and endows such organizations with the power to interact with the policy and curriculum formation process. In so doing, it addresses many of the underlying gaps in provider education on this critical issue and promotes equity in health outcomes for all patients. Keywords: LGBTQ health, continuing medical education, health policy