Health On The Range RURAL HEALTH ISSUES AND INFORMATION RESOURCES KATE FLEWELLING 9/17/15 1.

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Health On The RangeRURAL HEALTH ISSUES AND INFORMATION RESOURCES

KATE FLEWELLING

9/17/15

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What comes to mind you think “Rural”?

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More Than One Way To Slice It

Unit needs to be small enough to identify important community differences…

But not so small that little data are available

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The Definition Depends…Administrative:

Used by rural development programs. Defines urban/rural along municipal or other jurisdictional boundaries.

Land-Use: Used by the Census Bureau. Defines urban/rural based on how densely

settled the area is (like what you would see from an airplane).

Economic: Used in most rural research. Recognizes influence of cities on labor, trade,

and media markets that extend beyond densely settled cores.

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Metro and nonmetro countiesImage source: USDA

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More Than One Way To Slice It (2)

For research projects and economic development programs alike, the appropriate definition of rural will be that which meets the goals of the endeavor.

Amber Waves Magazine

June 2008

“Defining the ‘Rural’ in Rural America”

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Check Your Location

Rural Assistance Center: http://www.raconline.org/amirural

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Common Attributes of Rural Culture

Courage, faith, hope, trust

Relational, sense of community

Love and respect for life, land and God

Independence, self-reliance, individualism

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Common Attributes of Rural Culture (2)

Strong work ethic, perseverance

Hardships, troubles, afflictions

Enduring sense of gratitude

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Hallmarks of Rural America Rural America comprises 75-80% of the nation’s land area

Is home to 25% of the U.S. population

Of the 3141 counties in the U.S., 2049 (65%) are designated non-metro or rural by the US Census Bureau

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Hallmarks of Rural America (2) Low population density

Limited to no services

Disproportionate numbers of elderly, low-income/poverty and minorities

Social isolation

High incidence of chronic illnesses and premature deaths

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Hallmarks of Rural America (3) Rural areas are experiencing a decline in population of individuals under 20 years of age

They are also experiencing a corresponding increase – 7.8% - of individuals in the 40-59-year-old age group

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Hallmarks of Rural America (4) Transportation issues

◦ Costs are disproportionately higher

◦ More dependent on personal vehicles and have to travel longer distances

◦ Transportation issues can limit access to healthcare and other services

◦ 2/3 of deaths from motor vehicle accidents occur in rural areas (National Rural Health Association)

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Rural Disparities Rural Residents Are More Likely To:

◦ Have unintentional injuries and injury-related deaths

◦ Be living in poverty or on low-income with lower educational attainment

◦ Suffer premature death from heart disease, cancer, diabetes and suicide

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Suicide rates in the USA

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Rural Disparities (2) Rural Residents Are More Likely To:

◦ Be older and in poorer health with more physical limitations and disabilities

◦ Suffer from chronic or serious illnesses and depression

◦ On Medicare, uninsured, or under-insured

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Rural Disparities (3) Rural Residents Are More Likely To:

◦ Have high incidence of substance abuse and domestic abuse

◦ Lack ready access to health screening, health care and home and community-based services

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Rural Disparities (4) Rural Residents Are More Likely To:

◦ Lack convenient access to primary care, emergency services or specialty care

◦ Not exercise regularly

◦ Not use preventive screening services or use seat belts

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Rural Elderly Disproportionate number of elderly living in rural communities

◦ Chronic health conditions and disabilities

◦ In poorer health than urban counterparts

◦ Live in poverty/lower income than urban counterparts

◦ Low health literacy

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Environmental Health

"Polluted Animas River" by Mor is licensed under CC BY 2.0

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What Contributes to Disparities?

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Unique Health Information Needs

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Where To Turn?

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Rural Assistance Center Agricultural Health and Safety

Tribal Health and Human Services

Border Health

Finding Statistics and Data Related to Rural Health

Rural Health Disparities

Telehealth Use in Rural Healthcare

Migrant Health

Over 60 Topic Guides!

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State Guides• Organizations

• Funding Opportunities

• Data and Statistics

• News

• Events

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RAC Customized Assistance Identify potential funding opportunities

Locate appropriate federal or state agency contacts

Find and print electronic documents

Locate statistics, data sources and maps

Connect to organizations, experts, and colleagues

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MedlinePlus.gov•Farm Health and Safety•Motor Vehicle Safety•Suicide•Health Disparities•Heart Disease•Diabetes•Pesticides

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NLM’s Health Services Research Rural Health Page

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ToxTown

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Household Products Database

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ToxMap.nlm.nih.gov

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Health Hotlines(also a mobile app)

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Resources for Under- and Uninsured:Affordable Care Act (ACA)Healthcare.gov

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National-Level Associations and Agencies(Links on your handout)

National Rural Health Association

Leadership on Rural Health Issues Rural Assistance Center

Rural Health and Human Services Information Portal National Rural Health Resource Center

Dedicated to sustaining and improving health care in rural areas

Federal Office of Rural Health Policy

Coordinates activities related to rural health care within HHS

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National-Level Associations and Agencies(Links on your handout) (2)

United States Department of Agriculture (USDA)

“Home” for the Secretary of Agriculture – many programs USDA Cooperative Extension Centers

Granges, 4H for Youth

Educational network serving rural areas and other communities Community and Environment in Rural America (CERA)

Project on changing social, economic, and environmental factors in different rural parts of the country

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Funding Opportunities

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Search for funding at Rural Assistance Centerhttps://www.raconline.org/funding

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Funding Opportunities (2) Many of the organizations I just mentioned offer funding, especially:

Office of Rural Health Policy (HRSA)

USDA

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Funding Opportunities (3) There’s also:

Robert Wood Johnson Foundation

W.G. Kellogg Foundation

And many others, including…

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Funding Opportunities (4) Health Information Outreach Projects

Focus on under-served, under-represented groups (rural counts!)

http://nnlm.gov/funding/

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Practice Exercise Complete by September 25, 2015

(no extensions)

Email to flewkate@pitt.edu

Subject line: Practice Exercise

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Questions?

Photo credit: Kate Flewelling

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Thank You!

This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00003-C with the University of Pittsburgh, Health Sciences Library System.

Kate Flewelling, MLISNational Network of Libraries of Medicine, Middle Atlantic Region

http://nnlm.gov/mar/flewkate@pitt.edu