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in laughter. Tammy has come to MMO with her friend who is won- dering if Tammy should talk to any reporters. "The last time I did that," says Tammy's friend, "I was on the front page of the paper for prostitution." That really rubbed her the wrong way, " … be- cause I was volunteering for an organization giving out condoms. That's why I was on the street!" But Tammy is undaunted by her friend's experience with jour- nalists. She volunteers that she's just entered a court-ordered, in-patient rehab program and is pleased to be there. "I'd been in different out-patient programs and kept testing dirty," Tammy says, and insists she is ready to do the work nec- essary to get clean. "Drug use has gotten me nowhere. I want to find a life without drugs." The Character of Rural Areas To understand the nature of health care in the rural setting, it helps to understand the character of the rural population and their health care providers. Some 45 million Americans are unin- sured and, as the California State Rural Health Association and Mobile Medical note, a larger proportion of rural residents are uninsured than urban residents. Unemployment is higher in rural areas, averaging close to 10 percent. Those figures are skewed by counts that do not accurately factor in the rural homeless, nor people who do not receive unemployment compensation. Across the nation, 2.5 million rural children live in poverty. Although rural patients use Medicare more often than urban ones, an increasing number of rural doctors are not taking new Medicare patients. Low Medi-Cal reimbursement rates deter many private practice doctors from accepting Medi-Cal, with the burden of care often falling to clinics. There are 935 rural resi- dents per doctor, in contrast to 460 urban residents per doctor, and most rural areas have an inadequate supply of physicians, physician assistants and nurse practitioners. In addition, a larger percentage of Medicaid-dependent sen- iors live in rural areas compared with urban areas. Among migrant workers in rural areas, 70 percent are unin- sured. Undocumented workers are ineligible for any kind of fed- eral aid. C A L I F O R N I A N U R S E W W W . C A L N U R S E S . O R G M A R C H 2 0 0 6 15 MMO AND DISASTER RELIEF In early September, Dr. Wendy Ring of Mobile Medical led a team of health professionals, including a mental health counselor, to Houston, Texas to care for survivors of Hurricane Katrina. Staff of Mobile Medical followed by out- fitting a mobile medical office to drive to Houston and bring health care directly to the people. If you'd like to contribute to this effort or to any of Mobile Medical Office's programs, contact Sally Hewitt, CEO of Mobile Medical Office, at 707-443-4666 x22, or make a donation at www.mobilemed.org.