This paper explores the broad definition of health in the rural context and relates it to policy, practice, and pedagogical challenges in providing access to services in rural areas. Historically, policy, practice, and teaching institutions have supported a dependency model for health service delivery, forcing rural communities to rely on urban-oriented health policy, urban-based training models, corporate or large bureaucratic service delivery structures, and specialized care incentives not easily supportable in sparsely populated areas. In New Mexico, the percentage of population over 65 in nonmetropolitan areas is 14.1 percent. Additionally, there is a 32 percent difference in income between urban and rural people in New Mexico. These retiree and income statistics translate to a lack of tax base and political voice for rural populations compared to their urban counterparts. Rural health services are inadequate and there are insufficient providers. Although a critical component of a system of services, traditional services are crisis-oriented and "fixative." That is, providers are taught to simply fix physical and emotional problems, failing to respond to the underlying causes of trauma. It is only when root problems are addressed in the community setting that the health system becomes truly effective and curative. Financing strategies should include the following objectives: developing programs that support locally "grown" and trained primary health care professionals, changing the perception that rural communities are incapable of performing complex or high-technology tasks, establishing a strong health promotion and illness prevention component, maintaining a primary care focus, and developing appropriate non-community-based relationships. This paper also addresses the role of health policy, support systems, and community development in meeting these goals. (LP)