Nurse practitioners providing health care to rural and underserved areas in four Mississippi Delta states.

The aims of the study were to examine the nurse practitioners' (NP) workplace distribution, the relationship between the NPs' racial/ethnic characteristics, and the demographic characteristics of Mississippi Delta counties; and the NPs' practice in communities designated as health professional shortage areas (HPSAs). A total of 453 NPs from Arkansas, Tennessee, Mississippi, and Louisiana returned surveys (42 per cent response rate). More than 50 per cent of the NPs worked in physician private practice or hospital/medical centers. Fifty-nine per cent of the NPs practiced in rural areas whereas 31 per cent practiced in HPSAs. The proportion of NPs practicing in rural settings in each state exceeded the percentage of the population identified as rural in each state; however, there were weak relationships between NPs' practice sites in counties with greater numbers of minorities or poor citizens. NPs had a tendency to work in counties with a higher percentage of poverty, black citizens, and sewers. NPs were less likely to work in counties with better-educated citizens and in counties with larger percentages of Hispanic citizens. African-American NPs tended to practice in counties with higher percentages of African-American citizens.