Chapter 21 Promoting Healthy Partnerships With Rural Communities Community as Partner Chapter 21 Promoting Healthy Partnerships With Rural Communities

Rural Health Rural Health Clinical peripherality in developing countries in Australia, New Zealand In the United States Clinical peripherality Rural Health

Addressing the availability of primary and acute health care services Shift toward a population health approach Institute of Medicine Statement Census Bureau Definition of Rural White House Office of Management and Budget Definition of Rural Rural Health

Rural Areas Multitude of definitions Geography in the United States is not dichotomous Dividing populations into rural and urban denies the complexity and richness of the human experience Continuum from large urban core to rural counties as a method of developing complexity Rural Areas

Geographical and Social Factors that Impact Health in Rural Areas Development of urban ratio compared to rural ratio Assumption that adequate health services are necessary for population health National Center for Health Statistics Population health indicators Rural populations less healthy in nearly all indicators Why do rural people make unhealthy choices? Are there social and cultural factors that reinforce unhealthy behavior? Geographical and Social Factors that Impact Health in Rural Areas

An approach that focuses on interrelated conditions and factors that influence the health of populations over the life course Identifies systematic variations in their patterns of occurrence Applies the resulting knowledge to develop and implement policies and actions to improve health and well-being Population Health

A classic premise of community health is that the determinants of population health and particularly of health behaviors, are embedded in relationships that tie individuals to: Urban areas Cities Their communities The local government The State Judicial System Question 1

Answer: C A classic premise of community health is that the determinants of population health and particularly of health behaviors, are embedded in relationships that tie individuals to their family and friends, their neighborhoods, and their communities. Answer 1

Rural America Demographically different from Urban America Worse off in age, education, income, and health insurance status Diversity within rural populations Persistent poverty Rural America

Rural Socio-demographic Characteristics Risk for unhealthy behaviors Poor health status Lack of transportation decreases access to services Compounds many urban-rural disparities Rural Socio-demographic Characteristics

Negative Health Behaviors Why does rural residence reinforce negative health behaviors? Avoid stereotyping Rural communities may be high in social capital, but low in tolerance for diverse opinions or behaviors leading to pressure to conform Changes in diet difficult Negative Health Behaviors

Positive Approaches to Health Behaviors Rural community can come together to address a health issue Case of Albert Lea, Minnesota, population about 18,000 Positive Approaches to Health Behaviors

Question 2 The key to the success of the Alberta Lea project was: Education of the community Well child and Well-adult clinics Getting the community behind the goal Fostering Compliance with food banks Utilizing governmental mandates Question 2

Answer: c With help from AARP and the United Health Foundation, the town launched the Vitality Project, with the goal of helping citizens live longer, healthier lives. (Buettner, 2010). According to one report, “ the key for Albert Lea was getting the community behind a goal that was not just about weight loss, but also about fostering family relationships, a sense of purpose and healthy living habits” (USA Today, 2009). Answer 2

Health Promotion Issues that Relate to Rural Populations Same preventable illnesses as urban areas Practitioners as partners in health promotion Prevention initiatives Disproportionate threat of substance abuse and obesity Health Promotion Issues that Relate to Rural Populations

Childhood Obesity On the rise Long term medical and social consequences Lower rates of physical activity Role of active living Healthy Eating Research Rural Active Living Assessment (RALA) tools Childhood Obesity

Childhood obesity rates are highest among low- income populations and also among _____________. a. females b. males c. metropolitan areas d. racial/ethnic minorities Question 3

Answer: d Childhood obesity rates are highest among low- income populations and also among racial/ethnic minorities. Answer 3

Substance Abuse Alcohol most abused substance Rural teens – binge drinking Drive while intoxicated Methamphetamine and prescription drug abuse DARE Main Office of Substance Abuse Three pronged approach Substance Abuse

Resources Text and associated power points were utilized from: Anderson, E. & McFarlane, J. (2011). Community as partner: Theory and practice in nursing, 6th Edition. Philadelphia: Lippincott, Williams & Wilkins.  Resources