Rebuilding the Unity of Health and the Environment in Rural America Workshop Summary (2006) / Chapter Skim
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2 The Social Environment in Rural America
2 The Social Environment in Rural America
Pages 25-46
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From page 25... ...
Although many of those at the workshop are from Iowa or elsewhere in the Midwest, the United States has many types of rural settings different from those in the Midwest. The almost infinite variety of rural areas means that in terms of health issues, policies, and programs, what might work for one rural area may not be adequate for another because the needs of these various rural areas are different, according to Sandra Charvat Burke of Iowa State University.
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From page 26... ...
. However, the percentage for Nevada can be misleading because there are vast areas of open country in Nevada consisting of sagebrush and desert where no people live, noted Burke.
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From page 27... ...
In Iowa, many counties have had and continue to have declining populations, but other nonmetropolitan areas in the western part of the country are growing rapidly. Burke noted that as the population increases, the health care demands in those areas differ from those in areas experiencing population declines.
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From page 28... ...
As a result, these counties may experience seasonal peaks and troughs in health care demand and have a particular need for special types of health care services, such as those needed to treat people involved in accidents. Finally, retirement, although it is not an economic activity, has also influenced the economics and health care situations in various parts of the country.
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From page 29... ...
That small cohort of individuals is the one that has become age 65 and older in recent years. Thus, in the current decade, the older people died off and those entering the 65-plus age category are a smaller group, noted Burke.
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From page 30... ...
Burke concluded that while the patterns for Native American, Asian, and African American populations did not change radically from 1990 to 2000, the size of the Hispanic population changed dramatically across much of the country. LANGUAGE, CULTURE, AND HEALTH The issue of demographics is a serious one for Iowa, said John-Paul Chaisson-Cardenas of the Iowa Division of Latino Affairs.
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From page 31... ...
. place consist of not only the size of the Latino population, but also the locations where that population chooses to live (Population Resource Center, 2005)
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From page 32... ...
The growth pyramid for the Latino population is significantly different from that for the Caucasian population. Whereas the graph in Figure 2-3 exhibits a bulge contributed by the Baby Boom generation, which corresponds to the group that is now 4159 years old, the pyramid for the Latino population shows a large group in its 20s (Ramirez and de la Cruz, 2002)
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From page 33... ...
In such a relationship, it is the burden of the professionals to adapt to the culture of the people they are trying to serve. For example, if a Latino is seeking help from a mental health professional and the professional does something that insults the patient or breaks the relationship so that the two individuals cannot build a rapport, the breakdown is not a result of the patient's Latino culture but rather a result of the professional's lack of skills.
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From page 34... ...
RURAL INFRASTRUCTURE: ENVIRONMENTAL HEALTH AND BEYOND As mentioned above, some significant differences exist between rural and urban populations and between rural and urban health care delivery systems. When actions at the local rural community health level are planned or information on national policy decisions with implications for rural health is sought, it is
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From page 35... ...
To respond to health care challenges such as obesity in many rural communities, one would generally find strategies that are used in a personal health care delivery system, as opposed to a population health approach, noted Wakefield. Hence, one would likely see a focused health care system response to deal with an individual who is overweight or obese.
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From page 36... ...
, which discusses the need to engage other sectors and focus on community health by addressing issues that include environmental health, business, agriculture, and education. The IOM report begins to build a platform designed to strengthen rural health and the rural environment by meaningfully linking relevant dimensions of the built, the natural, the social, and other environments that characterize rural America and proposes five strategies to achieve that end, noted Wakefield.
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From page 37... ...
As a result, the rural health care sector is tightly linked in important ways to the economic health of rural communities, thereby highlighting the importance of ensuring the financial stability of rural health care systems. Finally, the fifth strategy for ensuring an adequate health care infrastructure in rural communities outlined in the IOM report revolves around investing in and building information and communications technology infrastructure.
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From page 38... ...
As a corollary of this principle, the IOM report concluded that health care providers share responsibility with other groups, such as consumers, educators, employers, governments, and religious organizations in rural communities, to work together to achieve positive population health outcomes. Similarly, the local rural infrastructure should reflect collaborative efforts at the community level to create environments that minimize the likelihood of illness or disease and to provide incentives to residents of rural communities to pursue healthier lifestyles.
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From page 39... ...
Rural Health Care Workforce Many external forces impinge on rural communities today, such as government policies, urban issues that are generalized to rural communities, and payment policies. For this reason the IOM report discussed the need for strong leadership to address not only what is going on within rural communities but also those events in the external environment influencing the health status of rural communities, noted Wakefield (IOM, 2004)
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From page 40... ...
The problems associated with mental health in rural areas have many facets, and as a result, many people, institutions, and organizations work diligently to improve the social and mental health of rural Iowa and rural America, said Cecilia Arnold of the Ligutti Rural Community Support Program. Perhaps the best way to examine these many facets of rural mental health is through a review of the overall situation in rural areas that affects the mental health of rural dwellers and then through a specific look at depression and three population groups.
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From page 41... ...
Rural Mental Illnesses: Depression Looking at a general picture of rural mental illnesses -- and at depression in particular -- the report of the Rural Women's Work Group of the Rural Task Force of the American Psychological Association (APA) and the American Psychological Association's Committee on Rural Health (APA, 2005)
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From page 42... ...
Another prominent issue in rural America is the abuse of methamphetamine, a drug that is very dangerous to manufacture and seriously addictive. A meeting of the National Catholic Rural Life Conference in early November 2004 listened to various anecdotal reports from farmers and clergy in Kansas, North Dakota,
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From page 43... ...
Rural Mental Health in Selected Populations Specific factors affect the mental health of various population groups in rural America. The first of these groups is the elderly.
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From page 44... ...
Despite the challenges presented by the special populations described above and other mental health concerns, all of Iowa has many fundamental common strengths. For example, rural people in general are generous and willing to go out of their way to help their neighbors, noted Arnold.
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From page 45... ...
At a recent focus group of the Iowa Rural Health Association, it was suggested that as a first step in looking at solutions, an assessment be made of the help needs of each community or region. Knowledge of the specific needs, the existing infrastructure, and the strengths of a community or region would allow meaningful, workable, and sustainable solutions to surface.
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