Handbook of Rural Health PDF
Preview Handbook of Rural Health
Handbook of Rural Health Handbook of Rural Health Edited by Sana Loue Case Western Reserve University Cleveland, Ohio and Beth E. Quill University of Texas, Houston Houston, Texas Springer Science+Business Media, LLC Library of Congress Cataloging-in-Publication Data Handbook of rural health/edited by Sana Loue and Beth E. Quill. p. cm. Includes bibliographical references and index. ISBN 978-1-4419-3347-8 ISBN 978-1-4757-3310-5 (eBook) DOI 10.1007/978-1-4757-3310-5 1. Rural health-Handbooks, manuals, etc. 2. Public health-Handbooks, manuals, etc. 3. Rural health services-Handbooks, manuals, etc. 1. Loue, Sana. II. Quill, Beth E. RA 771 .H26 2000 362.l'04257-dc21 00-062191 ISBN 978-1-4419-3347-8 © 2001 Springer Science+Business Media New York Originally published by Kluwer Academic/Plenum Publishers, New York in 2001 Softcover reprint ofthe hardcover 1st edition 2001 http://www.wkap.nU 10 9 8 7 6 5 4 3 2 1 A C.I.P. record for this book is available from the Library of Congress AlI rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any fonn or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Contributors Neva Abbott • Monroe, North Carolina Bruce W. Goldberg • Department of 28110 Family Medicine, Oregon Health Sciences University School of Medicine, Portland, Or Lu Ann Aday • University of Texas School egon 97201 of Public Health, Houston, Texas 77225 Jeffrey J. Guidry • Department of Health and Keith B. Armitage • Division of Infectious Kinesiology, Texas A & M University, College Diseases, Case Western Reserve University, Station, Texas 77843-4243 Cleveland, Ohio 44106-4984 Helena Hansen • School of Medicine, Yale Guadalupe X. Ayala • San Diego State Uni University, New Haven, Connecticut 06510 versity, Graduate School of Public Health and SDSU-UCSD Joint Doctoral Program in Clini Ardis Hanson • Louis de la Parte Florida cal Psychology, San Diego, California 92123 Mental Health Institute Library, University of South Florida, Tampa, Florida 33612-3807 Roberta D. Baer • Department of Anthropol ogy, University of South Florida, Tampa, Florida Robert Isman • California Department of 33620-8100 Health Services, Office of Medi-Cal Dental Services, Rancho Cordova, California 95670, John B. Conway • College of Health Sci and University of California at San Francisco, ences, University of Texas at El Paso, El Paso, San Francisco, California 94143 Texas 79968-0581 Leslie K. Dennis • Department of Epidemi Bruce Lubotsky Levin • Louis de la Parte ology, College of Public Health, University of Florida Mental Health Institute, College of Pub Iowa, Iowa City, Iowa 52242-1008 lic Health, University of South Florida, Tampa, Florida 33612-3807 John P. Elder • San Diego State University, Graduate School of Public Health and SDSU Sana Loue • Department of Epidemiology UCSD Joint Doctoral Program in Clinical Psy and Biostatistics, School of Medicine, Case chology, San Diego, California 92123 Western Reserve University, Cleveland, Ohio 44106-4945 Christine A. Gehrman • San Diego State University, Graduate School of Public Health Hal Morgenstern • Department of Epidemi and SDSU-UCSD Joint Doctoral Program in ology, School of Public Health, University of Clinical Psychology, San Diego, California California at Los Angeles, Los Angeles, Cali 92123 fornia 90095-1772 v vi CONTRIBUTORS Keith J. Mueller • Center for Rural Health Cielito C. Reyes-Gibby • University of Research, University of Nebraska Medical Texas School of Public Health, Houston, Texas Center, Omaha, Nebraska 68198-4350 77225 Susan Murty • School of Social Work, Uni Everett R. Rhoades • Native American Pre versity of Iowa, Iowa City, Iowa 52242 vention Research Center, University of Okla homa College of Public Health, Oklahoma City, Marie Napolitano • Department of Primary Oklahoma 73104 Care, Oregon Health Sciences University School of Nursing, Portland, Oregon 97201 James Robinson III • Department of Social and Behavioral Health, School of Rural Public Health, Texas A & M University System, Health Janice Nichols • Department of Anthropol Science Center, College Station, Texas 77843- ogy, University of South Florida, Tampa, Florida 1266 33620-8100 Gary I. Sinclair • School of Medicine, Case Karen Olness • Department of Pediatrics, Western Reserve University, Cleveland, Ohio Case Western Reserve University, and Rainbow 44106-4984 Center for International Child Health (RCIC), Rainbow Babies and Children's Hospital, Cleve Gail E. Souare • Alliance Healthcare Foun land, Ohio 44106-6003 dation, San Diego, California 92123 Stacie L. Pallotta • Department of Epidemi Lorann Stallones • Colorado Injury Control ology and Biostatistics, School of Medicine, Research Center, Department of Environmen Case Western Reserve University, Cleveland, tal Health, Colorado State University, Fort Ohio44106 Collins, Colorado 80523-1676 Judith J. Prochaska • San Diego State Uni Elizabeth Wheeler • School of Nursing, Uni versity, Graduate School of Public Health and versity of Vermont, Burlington, Vermont 05405 SDSU-UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California Patricia Winstead-Fry • School of Nursing, 92123 University of Vermont, Burlington, Vermont 05405 Beth E. Quill • University of Texas School of Public Health, Houston, Texas 77225 Marion F. Zabinski • San Diego State Uni versity, Graduate School of Public Health and L.A. Rebhun • Department of Anthropol SDSU-UCSD Joint Doctoral Program in ogy, Yale University, New Haven, Connecticut Clinical Psychology, San Diego, California 06520-8277 92123 Preface This book integrates the expertise of profession tion available on the various health concerns and als from a broad array of disciplines-anthro subpopulations and by the numerous method pology, health services research, epidemiology, ological complexities in compiling the neces medicine, dentistry, health promotion, and so sary data. Recognition of the nuances within and cial work-in an examination of rural health across rural populations, as recommended here, care and rural health research. This investiga will allow us to provide care more efficiently tion includes an inquiry into issues that are uni and effectively and to prevent disease or ame versal across rural populations, such as public liorate its effects. Reliance on some of the newer health issues and issues of equity in health care. technologies and approaches discussed here, Several chapters explore the health care issues such as distance learning and broad-based, com that confront specified subpopulations includ munity-wide health initiatives, will facilitate ing, for instance, migrant workers and Native disease treatment and prevention in relatively Americans, while others provide a more focused isolated areas. Ultimately, all of us must work approach to diseases that may disproportionately to ensure the availability of adequate health care have an impact on residents of rural areas, such to even the most isolated communities, for "as as specific chronic and infectious diseases. we all know, it is we collectively who are re Several common themes emerge, despite the sponsible for allocating and reallocating variation in the disciplines from which the au responsibilities ... we who appoint the judges" thors hail and the substantive areas of their in (Baier, 1995). quiry. The development of additional mecha nisms for the provision of care by health care professionals and an increase in the accessibil References ity of that care to rural consumers constitute major challenges. This task is rendered even Baier, A. (1995). Moral prejudices. Cambridge, MA: more difficult by the relative dearth of informa- Harvard University Press. vii Contents 1. Rural Health Policy: Past as a Prelude to the Future . . . . . . . • . . . . . . • . . . . • . 1 Keith J. Mueller 2. Methodological Issues in Rural Health Research and Care • • • . • • • . • • • . . . . . 25 Sana Loue and Hal Morgenstern 3. Public Health Issues . . . . . • . . . . . . . . . . . . . • • . . . . . . . . . . . . . . . • . . . . . . • . • . • 35 John B. Conway 4. Equity in Rural Health and Health Care . • • • • • • . . . . . . . . . • . . . . . . . • . • • • • . 45 Lu Ann Aday, Beth E. Quill, and Cielito C. Reyes-Gibby 5. Ethnic Issues . • • • • . • . . . • . • . . . . . . . . . • . . . . . . . • . • . . . • . . • • . • • • • . . . . . . . . 73 Roberta D. Baer and Janice Nichols 6. The Health of Migrant and Seasonal Farmworkers •...•••.•.•........... 103 Bruce W. Goldberg and Marie Napolitano 7. American Indian and Alaska Native Health Services as a System of Rural Care ••.....••••.....•...........••.•...................... 119 Everett R. Rhoades 8. Rural Women's Health ..........•.........•......................•.. 135 Patricia Winstead-Fry and Elizabeth Wheeler 9. Pediatric and Adolescent Health . . . . . • . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . 157 Neva Abbott and Karen Olness 10. Infectious Diseases. • • . . . . . • . . • . . . . . • • • • . . • . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Keith B. Armitage and Gary I. Sinclair 11. Chronic Disease in Rural Health . . • . . . . . . . . . • . . . . . . . • . . . . . . . • . • • • . . . . . 189 Leslie K. Dennis and Stacie L. Pallotta 12. Rural Occupational Health and Safety .•...•...•.•...••.••.•••••....... 209 Lorann Stallones ix x CONTENTS 13. Oral Health .•.••...........•.••.•.•.•....••....••.•••.•.......•••. 217 Robert Isman 14. Rural Mental Health Services ...........••...•...........••.•.....••• 241 Bruce Lubotsky Levin and Ardis Hanson 15. Substance Use ...........••...................................•.•.. 257 L. A. Rebhun and Helena Hansen 16. No Safe Place to Hide: Rural Family Violence •.........•................ 277 Susan Murty 17. Theories, Models, and Methods of Health Promotion in Rural Settings ..•.. 295 John P. Elder, Guadalupe X. Ayala, Marion F. Zabinski, Judith J. Prochaska, and Christine A. Gehrman 18. Health Education: Community-Based Models •••......••••••........•.• 315 Gail E. Souare 19. Recruiting, Training, and Retaining Rural Health Professionals •.......... 337 James Robinson III and Jeffrey J. Guidry Index .............•....•..•.•••..........••.•..........•.......... 355 1 Rural Health Policy Past as a Prelude to the Future KEITH J. MUELLER "You've come a long way, baby." This well Child Health Insurance Program (SCRIP) BBA known slogan comes from advertisements for Refinement Act of 1999 (Refinement Act), poli Virginia Slims cigarettes, introduced with great cies began to recognize that circumstances fanfare as cigarettes for women. Seeing women might warrant different approaches in rural ar smoke was one more indication in the 1960s eas. Because rural delivery systems were dif and 1970s ofthe cracking of societal barriers to ferent than their urban counterparts at an ear equal treatment for women. Some progress. As lier time, reflecting on that time might inform we know now better than in the 1960s and future policy choices. 1970s, getting more women to smoke was to This chapter will begin with the premise that confuse apparent equity and the best interests the past can inform the future in an opening sec of the target population. Is the same thing true tion articulating the historical perspective. A of striving for equity in health care services? Is second section will examine some threads in it in the best interests of rural residents to have public policy concerning rural health care de the same system as that available to urban resi livery that weave through the various policies dents? Are we making the cigarette example and across time. The third section will look at mistake of confusing equal access to the same the current dominance of payment as the driv delivery system with the ultimate goal of im ing force behind public policy, including an ex proved quality of life? amination of Medicare policies. The fourth sec Public policy is easily driven by simple, eas tion offers scenarios for the future of rural health ily understood paradigms. In the 1990s the para policy, and the final section looks at the mecha digm driving much of health policy was one of nisms available to influence the direction of expanding consumer choice among a host of those policies. competing health plans. Hence, all national poli cies were crafted based on that approach and applied to rural health care systems, regardless Historical Perspective of appropriateness of fit. As the decade ended, on Rural Health specifically in the Medicare, Medicaid, and State One town, one doctor, health care for all ... fond memories of a time gone by in ru KEITH J. MUELLER • Center for Rural Health ral America? Perhaps so, but the stereotype of Research, University of Nebraska Medical Center, Omaha, Nebraska 68198-4350. frontier life permeated federal policy from the 1940s through the 1960s, in that an implicit Handbook of Rural Health, edited by Laue and Quill. Kluwer Academic/Plenum Publishers, New York, 2001. policy objective was to get resources located 1
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