Chapter 34 Rural Health Delmar Learning Copyright 2003

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Chapter 34 Rural Health Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning

Chapter 34 Rural Health Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company

Historical Overview of Rural Health • Trend toward urbanization • Rural nursing care •

Historical Overview of Rural Health • Trend toward urbanization • Rural nursing care • 1980 s § Closure of rural hospitals • 1990 s § Evolution of rural home health care Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Definitions of Rural • No consensus • Ethnic and cultural diversity • Frontier area

Definitions of Rural • No consensus • Ethnic and cultural diversity • Frontier area Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Federal Definitions • Urbanized area § Inhabited by 50, 000 or more individuals •

Federal Definitions • Urbanized area § Inhabited by 50, 000 or more individuals • Urban cluster § Inhabited by 2, 500 to 50, 000 people • Rural area § Inhabited by < 2500 people Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Metropolitan Areas • Contain one city with 50, 000 or more people Nonmetropolitan areas

Metropolitan Areas • Contain one city with 50, 000 or more people Nonmetropolitan areas • Classification • Economy types Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Rural and Frontier Values • Traditionally associated with quality of life • Diverse values

Rural and Frontier Values • Traditionally associated with quality of life • Diverse values Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Health status of Rural Residents • Poorer health than urban counterparts • Barriers to

Health status of Rural Residents • Poorer health than urban counterparts • Barriers to health care § § Lack of transportation Work schedule Lack of health care providers Distrust of health care providers Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Health Status of Rural Children • More likely to be uninsured • Decreased access

Health Status of Rural Children • More likely to be uninsured • Decreased access to health care • More likely to live in poverty Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Health Status of Non-metro Elderly • Decreased access to health care • Increased prevalence

Health Status of Non-metro Elderly • Decreased access to health care • Increased prevalence of chronic disease • Difficulty managing health care system Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Health Status of Rural Residents • Mental health • Farm workers • Migrant workers

Health Status of Rural Residents • Mental health • Farm workers • Migrant workers § § Housing Health care • Native Americans and Alaska natives Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Typology for Health Care Needs of Communities • Increased demand for elderly services §

Typology for Health Care Needs of Communities • Increased demand for elderly services § § Aging counties Retirement counties • Increased demand for obstetric and pediatric services § § Out-migration counties Boom counties Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Factors Influencing the Rural Health Care Delivery System • Health care § § §

Factors Influencing the Rural Health Care Delivery System • Health care § § § Availability Accessibility Acceptability Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Factors Influencing the Rural Health Care Delivery System • Poverty Basic necessities Health care

Factors Influencing the Rural Health Care Delivery System • Poverty Basic necessities Health care is a luxury § Access to care § Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Legislation and Programs Affecting Rural Health • Rural Occupational Safety and Health Act of

Legislation and Programs Affecting Rural Health • Rural Occupational Safety and Health Act of 1970 § § Provide safe working conditions Established federal agencies • Occupational Safety and Health Administration (OSHA) • National Institute for Occupational Safety and Health • (NIOSH) Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Legislation and Programs Affecting Rural Health • Migrant and Seasonal Agricultural Worker Protection Act

Legislation and Programs Affecting Rural Health • Migrant and Seasonal Agricultural Worker Protection Act – 1983 § Provides migrant and seasonal workers with rights • Wage rights • Working conditions • Work-related conditions Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Legislation and Programs Affecting Rural Health • Office of Rural Health Policy – 1987

Legislation and Programs Affecting Rural Health • Office of Rural Health Policy – 1987 § Promote development of rural health clinics • Rural Information Center Health Service • National Rural Recruitment and Retention Network § Encourages health care providers to work in rural areas Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Alternatives to Improve Rural Health Care • Telehealth § Uses technology to deliver health

Alternatives to Improve Rural Health Care • Telehealth § Uses technology to deliver health care • Emergency medical services § Barriers to receiving services • Rural health clinics § Underserved areas Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Nurse’s Role in Rural Health Nursing • Rural nursing § § Expert generalists Independent

Nurse’s Role in Rural Health Nursing • Rural nursing § § Expert generalists Independent role Social & professional roles intertwined Resourceful Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Professional-Community-Client Partnerships • Community residents and health care providers form partnership • Partnerships developed

Professional-Community-Client Partnerships • Community residents and health care providers form partnership • Partnerships developed to address specific health needs • Effective leadership required • Broad community support is essential Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company

Key Concepts • Evolution of rural health care • Diversity of rural populations •

Key Concepts • Evolution of rural health care • Diversity of rural populations • Migrant and seasonal workers at risk for illness • Access to care Chapter 34 Copyright © 2003 Delmar Learning, a Thomson Learning company