chapter_22 rural-migrant online

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Chapter 22: rural health and migrant health : 

Chapter 22: rural health and migrant health

What is rural? : 

What is rural? Rural is subjective Defined in terms of geographical location and population density, or it may be described in terms of distance Perception based upon experience

Slide 4: 

THERE IS NO TYPICAL RURAL TOWN. OF 254 TEXAS COUNTIES, 205 ARE RURAL. CLASSIFIED AS RURAL IF POPULATION IS <20,000. ABOUT 25% OF THE US POPULATION IS RURAL WITH THE SOUTH HAVING THE HIGHEST PROPORTION. 98% OF RURAL RESIDENTS ARE NATIVE BORN.

DOUGHNUT EFFECT. : 

DOUGHNUT EFFECT.

Rural : 

Rural Rural more closely knit than urban Rural residents are resistant to outsiders & prefer to interact with people they know Rural more independent & resist getting help from welfare programs See work as a priority Delay seeking health care until later stages

Rural Characteristics : 

Rural Characteristics Race: > Caucasians Marital Status: Married/Widowed Age: > Young and old Education: Fewer years formal schooling Employment Health Insurance: Tied to level of income

RURAL AS AN AGGREGATE : 

RURAL AS AN AGGREGATE Elderly make up 25% of rural area where urban is 12%. Texas = 30% 1 IN 4 Rural Americans live in poverty More children live with both parents Fewer households headed by women

Health Status of Rural Residents : 

Health Status of Rural Residents Poorer perception of overall health status Less likely to engage in preventative behaviors (BSE, pap smears, wearing seat belts) Chronic illness Hypertension, arthritis/rheumatism, CVD, COPD cancer Diabetes AIDS— More physical Limitations

Health status (cont.) : 

Health status (cont.) Health status of women, infants and children are less than optimal Higher infant/maternal mortality Children’s Health More likely to have a usual provider (FNP, GP) School nurse may be only health care provider the child sees

Mental Health : 

Mental Health Farm Stress: Recession & agriculture job losses Delay seeking care until emergency/crisis Endemic levels of Depression Increase in accidents & suicides in young men Domestic violence: Less likely to be reported Mistrust of mental health services

Barriers to Rural Health Care Services : 

Barriers to Rural Health Care Services Shortage of formal health care professionals (RN & MD) Closing of rural hospitals Out of 205 rural counties, 100 have critical shortages of primary care physicians Family/friends for health care advice Accessibility Distance/Traveling time Unpredictable travel conditions and roads

Migrant Workers : 

Migrant Workers Majority Latino American citizens or authorized to work Employed in agriculture on a seasonal basis Have temporary homes Seasonal farm workers work cyclically but do not migrate

MIGRANT LIFESTYLE : 

MIGRANT LIFESTYLE Annual income below the federal poverty line Rarely receive Workers Compensation, disability, or health benefits Family very important Females caretaker roles Male major decision maker

MIGRANT HOUSING : 

MIGRANT HOUSING Overcrowded living conditions, lack of sanitation, laundry , screens on windows, fans, heaters

MIGRANT HEALTH : 

MIGRANT HEALTH Higher infant mortality Shorter life expectancy More complex health problems Less access to dental, mental and pharmacy services Use ER for care Higher TB and Hiv rates

CHILDREN OF MIGRANT WORKERS : 

CHILDREN OF MIGRANT WORKERS Low school attendance Need to work for the family’s economic survival Leading causes of death: machinery, drowning and firearms/explosives Inadequate immunizations, dental caries, infectious diseases, malnutrition, pesticide exposure Often appear happy, outgoing, and inquisitive

MIGRANT BARRIERS TO HEALTH CARE : 

MIGRANT BARRIERS TO HEALTH CARE Lack of knowledge about services Can’t afford care: Medicaid often not option Heath care far from work/home and most do not have reliable transportation Use of folk healers Discrimination Lack of bicultural/bilingual HCP

Environmental and Occupational Risks : 

Environmental and Occupational Risks High risk occupations Agriculture related accidents result in a significant number of deaths and long term injuries Women and children operate dangerous equipment with little instruction and safety precautions Agriculture is the 2nd most dangerous occupation in America yet only 2% of the total workforce

Nursing in Rural Communities : 

Nursing in Rural Communities Acceptability Diverse responsibilities More than one work role Professional Isolation Design community-oriented programs Priorities: Prevent accidents, engage in more healthful lifestyle behaviors, reduce risk of chronic health problems

Slide 24: 

Nurses in rural areas play an Important role in community education, case finding, advocacy, and case management of rural residents