PROFESSIONAL DEVELOPMENT MODULE 3
July 17, 2014
Rural Health Issues in America
A bill before Congress, if passed, will legally define the term rural area. Government agencies modify their descriptions delimiting rural areas to fit their needs, and the ambiguous terminology causes confusion. Interpretation can difficult even with a well-codified definition of the rural population because the constituents vary. In 2002, the U.S. Department of Health and Human Services’ (HHS) established the Rural Assistance Center (RAC) to act as an information agent. The agency collects and interprets data to increase the accuracy of reporting. Rural Areas
United States Census Bureau (BOC) documented “the United States encompasses 3,537,438 square miles” (2011, p. 8) of land and National Alliance on Mental Illness (NAOMI) documented “90% classified of the US landmass is rural” (n.d. para. 11). The Census Bureau (BOC) reported that as of 2010, the US population density was “87.4 per square mile” (BOC Geography QuickFacts, 2014, line. 2). RAC data recorded a population density of “13 per square mile” (RAC, n.d. para.2) in rural areas. Rural Health Disparity
A review of Pub Med and ProQuest failed to identify a single peer-reviewed source that claimed equal access to quality health for all. Rural populations in the U.S. represent an aging heterogeneous society, composed of a range of socioeconomic variables and racial-ethnic groups. Rural America exists in pocketed homogenous societies dispersed across geographic regions of the country. Ethnic, geographically dependent and behavioral similarities exist within individual subcultures and contribute to homogenous health disparities specific to that subgroup. Examples of this phenomenon would include communication problems among non-English speaking residents or the tendency among persons from northern European descent to develop skin cancers. The existence of heterogeneous conditions detrimental to health and universal health risking behaviors exist across the spectrum of rural subgroups, linking the inhabitants of the different subcultures and form a collective rural culture. A common phenomenon among the larger rural culture provides an opportunity to target large-scale preventable risk factors for chronic diseases. The estimated the cost to the U S. Economy related to multifarious health disparities according to the Keiser Family Foundation(2012) was“$309 billion dollars per year” (para. 2). Rural health disparities occur across the gamut of geography in all racial and ethnic populations. However, poverty as a common thread in all health disparity crosses the imaginary boundary between rural and urban societies as well as the respective sub-boundaries. After eliminating economic health disparities, the focal target of rural healthcare becomes addressing the health threatening behaviors specific to a cultural subgroup. In reviewed studies, persons in rural communities tended to be more elderly had lower incomes, lower education achievement and had less access to affordable healthcare than in urban areas. Rural communities had higher age-related mortality and increased incidences of chronic disease. The predictable outcomes corresponded with rural behaviors which included: (a) less physical activity; (b) higher incidences of alcohol abuse; (c.) higher rates of obesity; (d) higher tobacco use (Institute of Medicine [IOM], 2005; Adler & Newman, 2002; National Center for Health Statistics, 2012; Traci, Russell, Yvette, White, & McClean, 2012). Presenting education as the cornerstone to eradicating health disparity, Freudenberg and Ruglis (2007), told the centers for disease control, “Improving educational achievement among populations and the associated effect on earning potential, offers the best method of reducing health disparities” (para. 3). Rural Health Provider Challenges
The healthcare systems of rural America consist of small...
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