There is good news about healthcare improving in rural USA, where healthcare has lagged in comparison to metropolitan areas. Several recent news and journal reports indicate progress in healthcare delivery in rural America, particularly in regions where agriculture predominates.
Recent newscasts and newspaper articles report the Affordable Care Act (ACA) enrollment figures indicate rural residents are signing up for healthcare insurance in significant numbers in areas where insurance coverage has been lower than in metropolitan areas.
Furthermore, the USDA announced a $50 million fund in December to improve rural mental health facilities—another positive step toward improving rural healthcare.
An article in the latest issue (Winter 2014) of The Journal of Rural Health indicated there were no significant differences in the outcomes of treatments for strokes among patients in 18 rural Veterans Administration (VA) hospitals versus 110 urban VA hospitals. The same journal also reported samples of rural and urban Missouri physicians were equally concerned about preventive care, but rural residents were more resistant to undertaking preventive health measures.
Rural areas where agriculture is the main economic force seem to be making more progress in healthcare than many nonfarm rural areas. What explains this?
Not all rural areas are alike. The U.S. Census indicates rural people are poorer and less well educated than residents of most metropolitan areas except in well-to-do farming communities, such as many agricultural communities in the Midwest.
Perhaps the positive upturn in many segments of the farm economy over the past few years until just recently has increased tax receipts and donations available for agricultural communities to improve their health facilities and healthcare workforces. The average education level of 3.2 years of college for beginning farm operators possibly also enhances their thinking about health concerns.
The AgriSafe Network is a positive rural healthcare development. AgriSafe is a national nonprofit organization of rural nurses, doctors, researchers and other professionals who offer specialized health assessments, educational materials, personal protective equipment and follow-up services to persons engaged in agriculture.
AgriSafe trained healthcare providers are available in twenty states in the U.S. and in Australia. AgriSafe offers free webinars about agricultural health topics several times each month to anyone who wishes to subscribe. Information is available on their website: www.agrisafe.org.
Specialized agricultural medicine training has become available to physicians, nurses and allied healthcare providers in seven states and in Australia and Turkey. Healthcare professionals in agricultural regions are encouraged to attend the nearest 40-hour training, which is available on the website: cph.uiowa.edu/icash/education/ag-med-training/index.html.
Completion of an agricultural medicine course is required to be recognized as an AgriSafe certified provider, but other professionals are welcome. Feedback from the course attendees is uniformly positive, with many saying it is one of the best educational endeavors they have ever undertaken.
Serving on education, hospital and health boards and committees can become opportunities to establish agricultural health services and to encourage local healthcare providers to attend specialized training in the field of agricultural occupational health.
There are still too few providers of healthcare services in rural and agricultural regions who are versed in the particular health issues that can occur to farmers, ranchers and agricultural laborers. Lives can be saved if their healthcare providers know more about what to examine for and how to treat unique presenting problems, such as exposures to agrichemicals.
Education matters more to health than ever before, says a just-released report from the VCU Center on Society and Health (societyhealth.vcu.edu/Page.aspx?nav=307). Rural people who are less literate than average face serious health disadvantages.
The Robert Wood Johnson Foundation-funded report says persons with less education experience shorter lives, worse health as reflected by diabetes and heart disease, and are more likely to undertake risky health behaviors such as smoking and little exercise.
A nationally representative survey of healthcare avoidance among rural populations, which was undertaken by Pennsylvania State University researchers and also reported in the latest issue of The Journal of Rural Health, agrees. Poor rural residents are more likely to suffer health perils and less likely to undertake preventive measures, partly because they have less awareness of healthy behaviors and are more likely to reject advice.
Incentives to promote healthful behaviors are built into the ACA. The ACA pays for an annual physician visit to assess wellness and undertake basic health tests for persons receiving Medicaid or Medicare-funded healthcare and requires most private insurers to also cover an annual wellness visit.
Education about how to manage our own health gives all of us more control over our own destinies. Leaders in agricultural and other rural communities can have a significant impact on the health of community citizens by serving on local committees and boards where policies can be enacted to advance knowledge of healthy behavior lifestyles.
Dr. Rosmann lives near Harlan, Iowa. Contact him at: www.agbehavioralhealth.com.
By Mike Rosmann, Ph.D.