The Gap Between Rural And Rural Communities

Since 1980, the United States has taken on 10-year plans that outline certain key national health objectives set to be accomplished during a 10-year timeframe (Shi & Singh, 2015). These initiatives are founded on medical care with prevention services, health promotion, education, community health care, and increased access to integrated services. The initiative, Healthy People 2010: Healthy People in Healthy Communities, launched in 2000. The initiative emphasizes the role of community partners such as

The patient centered medical homes (“PCMH”) approach “focuses on keeping people well, managing chronic conditions like diabetes or asthma, and proactively meeting the needs of patients.” According to the Arkansas Department of Health, chronic diseases like cancer heart disease or diabetes affect approximately over fifty percent of adult Arkansans. Yet chronic diseases are often preventable. The high rate of chronic diseases can partly be attributed health insurance coverage—“when people don’t have health insurance they tend to avoid seeing doctors. People

As health care continues to evolve, these changes may facilitate or hinder the availability of health care resources for lower income populations. According to the American Association of Nurse Practitioners (2017), “By providing high-quality care and counseling, NPs can lower the cost of health care for patients” .Moreover, practicing at the primary care level, and focusing on prevention, counseling, and screening will help decrease the prevalence of inpatient hospitalizations due to people not understanding their health. As an FNP in primary health care setting, I will have the ability to see my patients for wellness visits, and reinforce the routine knowledge needed for them to make ideal life style choices, that will maintain their good health. The overall goal, which I want to obtain in this vital role is to change the mind set of individuals to disease

Given our rural veterans' and other non-veterans need for access to high quality healthcare, allowing nurse practitioners to practice with full authority in the rural and underserved areas will increase access to care, decrease lengthening delays in healthcare delivery, decrease healthcare costs, and promote patient safety. This is why I urge you to move forward with the proposal to recognize nurse practitioners to practice within their full scope in the rural and underserved urban

Majority of the community in Stockton lacked health insurance prior to Obama Care going into effect in 2014. Even though low-income families are now able to receive insurance at affordable costs or no cost at all, there are many health challenges within the community. Physical inactivity and unhealthy eating habits have led to obesity and multiple chronic diseases. According to the San Joaquin County Community Health Assessment Collaborative report (SJC2HAC) “diabetes, heart disease, stroke, and hypertension were consistently mentioned in the qualitative data as priority health concerns for the residents in the Communities for Concern” (SJC2HAC, pg.23, 2011). Five out of the ten communities for concern were Stockton zip codes. Unhealthy eating habits can be blamed due to the community of Stockton not having healthy retail outlets or access to fresh fruit/ farmers markets. Another reason why eating healthier is a challenge in this community is that fresh and healthy food is more costly. With households not making enough income, it is more convenient to grab fast food that is cheaper. “One of the largest barriers to engagement in physical activity is access to a recreational area” (SJC2HAC, pg.36, 2011). Some of Stockton’s rural areas may not have parks that are near by which can make it harder

Given that there is a shortage of physicians nationwide it is important to expand the scope of mid-level practitioners such as nurse practitioners and physician’s assistant, who are pivotal in treating the mass influx of patients, especially in underserved areas. Rural communities tend to be poorer, and unable to afford to hire enough physicians, and many rural Americans are less well insured, driving the cost of treatment up (RHF, 2015). The lack of resources and funding in underserved areas means even less incentive for physicians to practice in rural areas. Mid-level practitioners are trained to treat patients with low-level illnesses, provide care to patients with chronic and acute diseases, as well as refer patients with more complex issues

Americans living in rural areas have found out that getting access to quality health care is not only hard to obtain but very expensive. People who live in rural areas have the highest rates diseases that are chronic, poverty is higher, an having no insurance, and there are limitations to having access to primary care physicians to millions of rural Americans. Since the economy is going through a downturn, this has the potential to cause a rise in a number of access and health issues that are already causing problems in communities in rural areas.(HealthReform.Gov., 2012). This is where the new health care tax or the Patient Protection and Affordable Act of 2010 will play one of its greatest roles which is its main goal which is to allow coverage to all residents of the United States and thereby improving the delivery of needed health care to rural parts of America. (Becker & Dunn, 2012).

Multiple rural areas such as Mariposa are at a vast disadvantage compared to a urban city as San Francisco. In Mariposa, residents do not have a easy access to healthy markets and a safe community to be physically active. For example individuals in San Francisco have easier access to facilities such as gyms and facilities to work out in. While Mariposa’s citizens do not have easy access to facilities and do not have a safe area to go out for a run or walk(Urban Versus Rural Health Unite.com). Which leads to many individuals in San Francisco to become much healthier and are less likely to face heart diseases, diabetes and being obese. On the other hand individuals in Mariposa are much more in risk for heart diseases, cancer, stroke, and becoming

Research displays associable health behaviors in rural areas; “Rural adults are more likely than their urban counterparts to: smoke, abuse alcohol and other substances, be physically inactive, be obese, and have poor access to healthy foods. These poor health behaviors contribute to health disparities, such as disease incidence and lower life expectancies.” Cultural Care Connections, Rural Health (2015). These health behaviors are proven facts, which causes many acute and chronic problems in the rural community. The overflow of these problems without proper medical attention or resources, to endure these problems in the rural communities, are subjected to an increasing mortality rate for rural hospitals who experience these conditions.

There are two principal conditions leading to physician shortages in rural communities according to Wright and colleagues. They are “demand-deficient”, meaning they have insufficient populations and resources to support a physician practice, they are “ambiance-challenged,” meaning they are isolated, lack quality services and amenities, and/or are in geographically unattractive settings, or a combination of the two sets of conditions. Inner-city physician shortages are a more recently recognized issue. They are affected by the same conditions, though the specifics are different (Wright, Andrilla, and Hart 2001).

Nurses take on educator roles both in educating the public on their health and as educators in clinical practice and academic settings. As a public educator, nurses teach and counsel patients and families to enhance health and well-being. Patient and family health education is an important step in preventing disease. In order to be able to properly educate their clients on health promotion and well-being, nurses must first fully understand “health”. Nurses do not view health as “the absence of illness” but “define health as the extent to which an individual or group is able to realize aspirations, to satisfy needs and to change or cope with the environment in which they live.” (CARNA, 2005, p.2). Nurses hold a holistic view of the person and health and address health within the context of a person’s wholeness, including biological, emotional, psychological, social, cultural, and spiritual dimensions. Incorporating these ideas, nurses use the determinants of health as a way of dealing with and achieving health for an individual. Nurses recognize the broad determinants of health as income & social status, education, culture, physical environments, gender, health services, social support networks, employment & working conditions, health services, personal health practices, and biology & genetic endowment.

Proper nutrition is another key to helping the older adult stay healthy. Many older people tend to say that they know what is involved in a healthy diet but do not feel that the can afford to eat healthy (Walsh, 2015). A third component of this plan is finding ways to help the older adult in finding ways to coping with the mental stressors of daily life. The focus of these components of this plan will be discussed more in the context of this paper and will include some suggestion that would further benefit those in the rural communities. Each of these areas that this plan would promote can be promoted by different health care providers. This paper would like to discuss the disciplines that will help to promote this plan, potential communications that would happen among these disciplines. This paper would also discuss how the incorporate health plan is a culturally based plan. This plan will empower the individuals who participate in the plan and assist them to maintain their

Public health nurses "play a strategic role in helping reduce environmental and lifestyle-related health hazards by promoting a positive lifestyle, including exercise, stress management, accident prevention, weight maintenance, and nutrition education that is sensitive to socio-economic status and cultural beliefs” ("Obesity's Impact on Public Health Nursing," n.d.). Nurses can help by involving themselves in policy development by being active participants in the policy process as it closely resembles the nursing process. Through community assessments, public health nurses can determine health factors by assessing the socioeconomic, environmental, and behavioral factors of the population to determine interventions

A challenge that many rural communities are dealing with is the lack of primary care physicians, specialist, understaffed hospitals, and transportation. “Only about ten percent of physicians practice in rural America despite the fact that nearly one-fourth of the population lives in these areas” (National Rural Health Association [NHRA], n.d., para. 2). Although, there are programs designed to improve patients access to hospitals and physicians in rural areas, provider access for these patients remains a barrier. Technology can bridge some of the gaps of care for these patients and it can be beneficial in many ways. With enhanced technology, primary care physicians and patients will be able to have support, access to quality care, improvement in self-management skills, which ultimately, will improve a patient’s health. To assist physicians with delivery of optimal care and for patients to be able to go to scheduled wellness visits with physicians, a new approach to solving rural health barriers are needed.

This class allowed me to explore the current social milieu within the rural context. As such I have experienced a new appreciation for rural life and the systematic shifts that have taken place over the past decade such as globalization, market shifts, agricultural practices, advancements in education, and social norms that has and is drastically disrupting fundamental institutions of support and identity for rural life. One among the many of these institutions is the church as it maintains an essential role in rural life as it gives meaning and identity to such communities.