In rural communities, substance use, sexually transmitted diseases, and sex-related risk behaviors are on the rise. We know that national prevalence and surveillance data have been slow to capture this rise, and at times have actually misrepresented the real picture. Comparisons of metropolitan areas do not tell the whole story. Information gathered in rural areas can be problematic due to outdated data systems and patterns of under-reporting that do not effectively capture accurate data. Add to this blurry image fewer healthcare professionals with advanced education, health facility shortage areas, and sparsely located, isolated programs and services, and you have the makings of a crisis.

Fortunately, Cross-Training provides an opportunity to share information about local communities' needs and rural orientations, and for local decision-makers to develop a common vision and set of strategies for addressing substance abuse and infectious disease. Cross-Training in communities helps to develop local capacity for integration, partnerships, and collaborations, and helps to maximize potential between systems by helping to avoid duplication.