Rural and Migrant Health – Savvy Essay Writers | savvyessaywriters.net
Rural and Migrant Health – Savvy Essay Writers | savvyessaywriters.net
Week 8 lecture and discussion questions
Population Affected by Disabilities.
Rural and Migrant Health
Review the attached PowerPoint presentations. Once done, answer the following questions.
Mention and discuss the differentiation between the medical model and social construct definitions of disability.
Identify and discuss selected health care and social issues that influence the ability of people with disabilities to live and thrive in the community.
Mention and discuss the characteristics of rural community health nursing practice.
Mention and describe the features of the health care system and population characteristics common to rural aggregates.
As stated in the syllabus present your assignment in an APA format word document, APA required A minimum of 2 evidence-based references (besides the class textbook) no older than 5 years must be used.
A minimum of 800 words is required and not exceeding 1,000 words (excluding the first and reference page). Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.
Rural and Migrant Health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
Rural Populations
The largest rural population in history of United States is now.
75% of counties are classified as rural; they contain only 20% of the U.S. population
Number/size of rural counties are highest …
in the South (35%)
in the Midwest and West (23%)
in the Northeast (19%)
Census data
20% of nation’s children under 18
15% of nation’s elderly
More than 50% of nation’s poor
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Rural Populations (Cont.)
Economic base is shifting
Agriculture is the “food and fiber system”
All aspects of agriculture (core materials to wholesale and retail and food service sectors) are included
Poverty in rural areas greater than in urban areas
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Rural Populations (Cont.)
Poverty continues to be greater in rural America than in urban areas.
Aging-in-place, out-migration of young adults, and immigration of older persons from metro areas.
Greater diversity among residents: a country of immigrants historically and today.
Health disparities exist—rural population more likely to be older, less educated, live in poverty, lack health insurance, and experience a lack of available health care providers and access to health care
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Health Disparities Among Rural Americans
Only 10% of U.S. physicians practice in rural areas
Ratio of physicians in rural population is 36:100,000 (nearly double in urban settings)
More often assess their health as fair or poor
More disability days resulting from acute conditions
More negative health behaviors (untreated mental illness, obesity, alcohol, tobacco, and drug use) that contribute to excess deaths and chronic disease and disability rates
Higher number of unintentional injuries
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Defining Rural Populations
Population size
Rural = towns with population of less than 2500 or in open country [farm/nonfarm]
Density
Rural = fewer than 45 persons per square mile
Frontier = less than 6 people per square mile
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Defining Rural Populations (Cont.)
The Rural-Urban Continuum uses population and adjacency to metropolitan areas
Core Based Statistical Areas (CBSAs)
Metropolitan areas = county with at least one urbanized area of 50,000 or more people
Micropolitan area = area contains a cluster of 10,000 to 50,000 persons
Outside CBSAs = noncare areas
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Describing Rural Health and Populations
Differ in complex geographical, social, and economic areas
Disparities include key indicators of health:
Employment
Income
Education
Health insurance
Mortality
Morbidity
Access to care
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Rural Health Disparities: Context and Composition
Context: characteristics of places of residence
Geography, environment, political, social, and economic institutions
Composition: collective health effects that result from a concentration of persons with certain characteristics
Age, education, income, ethnicity, and health behaviors
– Braveman (2010)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Context: Health Disparities Related to Place
A downward spiral may exist:
people leave services are lost tax base becomes insufficient fewer services are provided long distances to get health care jobs become scarce and more people leave the cycle continues
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Context: Health Disparities Related to Place (Cont.)
Access to health care (#1 priority)
Fewer primary care physicians
General health services lacking
Health insurance coverage …
Varies according to race and ethnicity; age and residence (rural or urban)
Influences health patterns
May create financial barriers to health care
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Composition: Health Disparities Related to Persons
Income and Poverty
One of the most important indicators of the health and well-being of all Americans, regardless of where they live.
Regional differences—highest in the South
Racial and ethnic minorities—rates among rural racial minorities two to three times higher than for rural whites
Family composition—female-headed families have highest rates
Children—among the poorest citizens in rural America
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Composition: Health Disparities Related to Persons (Cont.)
Health risk, injury, and death
Higher rates of obesity, smoking, sedentary lifestyles, alcohol use, firearms usage, suicide, vehicular accidents; lower rates of seat belt use
Risk factors
Age, education, gender, race, ethnicity, language, and culture
Education and employment
Occupational health risks
Perceptions of health (gender, race, ethnicity)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Agricultural Workers
Accidents and injuries caused by:
Environmental conditions
Geographic isolation and working alone
Use of agricultural machinery
Delayed access to emergency or trauma care
Acute and chronic illnesses:
Musculoskeletal discomfort, acute and chronic respiratory conditions, hearing loss, hypertension
Chemical exposure (pesticides, herbicides, etc.)
Secondary conditions related to demanding farm work
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Migrant and Seasonal Farm Workers (MSFW)
Health Disparities
Poorest health and the least access
Low income and migratory status
Cultural, linguistic, economic, and mobility barriers
Minimal or no preventive care
Mobile clinic sites form a central link to health services
Migrant Health Program (MHP) bases services on enumeration of MSFW
Migrant and Seasonal Farm Worker Enumeration Profile Study (MSFWEPS) (2000)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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“Thinking Upstream” Concepts applied to Rural Health
Attack community-based problems at their roots
Emphasize the “doing” aspects of health
Maximize the use of informal networks
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Rural Health Care Delivery System
Health care provider shortages
Rural shortages likely to become worse
Need to “grow their own”
Telemedicine
Cost-effective alternative to face-to-face care
Telehealth includes telephones, fax machines, email, and remote monitoring
Telemedicine permits two-way, real-time, interactive communication between patient and provider
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Rural Health Care Delivery System (Cont.)
Managed care in the rural environment
Possible benefits:
Potential to lower primary care costs
Improve the quality of care
Help stabilize the local rural health care system
Risks
Probable high start-up and administrative costs
Volatile effect of large, urban-based, for-profit managed care companies
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Community-Based Care
A myriad of services provided outside the walls of an institution
Home health and hospice care, occupation health programs, community mental health programs, ambulatory care services, school health programs, faith-based care, elder services (adult day care)
Community participation in decisions about health care services
Focus on all three levels of prevention
An understanding that the hospital is no longer the exclusive health care provider
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Home Care and Hospice
Nurse case management and development of local resources
Often hospital based in rural areas
Use county extension services as a bridge for outreach services
Improve home care for these patients and provide support for their families
A partnership between the public health nurse and county extension service could provide support, as well as information groups and caregiving classes, for the important informal provider network.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Faith Communities and Parish Nursing
A strong sense of community, family life, and religious faith
Integrating nursing expertise and…
