Rural Health

Question 1

Census Bureau def of urban

Answer 1

50,000 or more people

Question 2

Rural vs Urban

Answer 2

Larger # of people <18 but >65 yrs
Rural residents >18 more likely to be married
More likely to be widowed
Fewer years of formal education
Rural families lower income and less likely to have private insurance, more likely to receive public assistance or be uninsured
Rural people have poorer perception of overall health and functional status (believe they are in worse health)

Question 3

Rural vs urban continued

Answer 3

-Rural more likely to have a general provider, not a specialist.
Access to care issue: travel, time
-Farm stress: Economic downturn in the ag industry as it impacts an ind. family and the community.
-High risk occupations: OSHA ID four high risk industries
-Accidents 50% higher, less likely to wear seatbelts, opioid use higher in rural areas

Question 4

Rural vs urban preventative care

Answer 4

Less likely to engage in preventative care
Higher risk of tobacco, ETOH abuse and obesity.
Rural more likely to have chronic health conditions.

Question 5

Health resources: school nursing

Answer 5

Scarce resources, rely on creativity and innovation for kids.

Question 6

T/F there is less available prenatal/pediatric specialty care in rural areas.

Answer 6

True

Question 7

T/F rural has higher infant and maternal morbidity rates as there is no care for at-risk populations, travel and time

Answer 7

True

Question 8

Rural mental health

Answer 8

Rural delay visits for mental health even when provided accessible; mental illness is prevalent among economically deprived individuals.

Question 9

Depression in rural communities

Answer 9

Poverty, isolation and geographics

Question 10

Rural women’s health

Answer 10

Poorer overall health than urban counterparts
Greater risk of unintentional injury
Greater mortality rates from: road accidents, CV disease, suicide.
Other factors: teen pregnancy, cervical cancer, substance abuse.

Question 11

Characteristics of rural health

Answer 11

Different health seeking behaviors
Use of complementary medicines
Place value on self-reliance

Question 12

T/F those in rural areas will more often opt for radical treatment

Answer 12

True

Question 13

Life as a rural nurse

Answer 13

Must be a jack of all trades:
Peds immunizations, STI testing, care of elderly, providing community education.
Is slower paced, more about relationships.
**Critical access hospitals.

Question 14

Rural traits

Answer 14

hardy, self-reliant, independent, conservative, work oriented, distrusting of newcomers, lack of anonymity.

Question 15

Use of complementary medicine in rural healthcare

Answer 15

Relief of symptoms, ineffectiveness of allopathic tx
Side effects f allopathic treatments
Concerns about adverse effects of allopathic tx
Availability
Desire for control.

Question 16

Who primarily in rural communities use CAM more?

Answer 16

Older, rural medicines

Question 17

Implications for CAM

Answer 17

Medication interactions- Warfarin
Side effects
Polypharmacy
Seeking care- doctoring at home before going in

Question 18

**!!That are the three stages/Response to Illness

Answer 18

Self care stage
Lay resource stage
Professional resource stage

Question 19

Response to illness: Stage 1) Self care stage

Answer 19

Get more rest

Watch and wait for more symptoms or resolution

Question 20

Response to illness: Stage 2) Lay resource stage

Answer 20

Friends and neighbors

Local ranchers

Question 21

Response to illness: Stage 3) Professional resource stage

Answer 21

“for emergencies”

“If there was nothing else I could do”

Question 22

Policy gaps identified

Answer 22

• Delay of public health emergency declaration
• No single agency is assigned oversight of the management and tracking of the exposed population
• Poor coordination among key federal and state agencies

Question 23

Ecological public health model

Answer 23

Address medical and nonmedical health determinants
Positive and negatives of social, economic, cultural and environmental factors interacting with biological and behavioral components.

Question 24

5 action strategies of the ecological public health model

Answer 24

1) Build healthy policy
2) Create supportive environments
3) Strengthen community action
4) Develop personal skills
5) Reorient health services.

Question 25

Rural access to care model

Answer 25

Recognizes unique challenges rural residents face daily

Lifetime continuum of care, social justice and 5 principles.

Question 26

5 principles of the rural access to care model

Answer 26

Health of the individual is paramount
Health is an individuals capacity to pursue needs
All individuals must have comparable opportunities to obtain services
Local resource capacities for health services
Public policy should facilitate an individuals understanding and navigation of the system.

Question 27

Community level model

Answer 27

Addresses the multideterminant and generational health needs of the community.

Question 28

Policy implications for PHN

Answer 28

PHN’s serve as advocates and leaders
Policy development is a core function of public health
Support equitable health services
Encourage healthy communities through using skills in assessment, program planning, and implementation and policy development.
Can work as community insiders to shape policy