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

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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

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

19. 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

20. 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