Rural, migrant, and urban health care

oh gee i sure do love cramming for an exam the night before yippeeeee

What health issues do rural residents face related to agriculture?

• Usage of pesticides → Health issues

• Well water may not be clean or pure, contaminated

• Occupational injuries (ever heard of the guy whose tractor fell on him?)

What are some barriers to health care that those living in rural areas face?

• Cost of care, limited choice of providers

• Travel (may not have a reliable means of transport)

• Weather

• Distance (can live a LONG WHILE from any office)

These factors may lead to use of folk treatments, home remedies

What approaches can be used to improve access to care for patients living in rural areas?

• Mobile/outreach clinics

• School-based clinics 

• Faith-based nursing 

• Telehealth

What are some health concerns that are commonly specific to migrant farmworkers?

• Heat-related illnesses (prolonged sun exposure)

• Pesticide and toxin exposure

• Injuries from equipment

• UTI — lack of toileting

• Animal and insect bites

• Infectious disease due to crowding (tuberculosis, covid)

• Mental health issues

True or false:

While migrant farmworkers face numerous health concerns, because they play an essential role in society, they have full access to medicare

FALSE

• Lack of eligibility for healthcare coverage → Major barrier for receiving healthcare

  • Eligibility may also be confusing, difficult to navigate. Especially due to language barriers and lack of information regarding coverage options

• Also, large fear of being reported to authorities

Characteristics of community health related to urban environment and large cities 

• Lack of connectedness 

• Lower overall levels of trsut 

• Weaker family and community ties 

• Increased population density + ghettos 

In regards to urban environments, what is an important determinant of health?

Housing issues

• Lack of affordable housing

• Also transportation costs

What characteristics of urban environments/communities lead to these traits in youth:

• Poor mental health

• Developmental delays

• Shorter stature

Overcrowding

Poor-quality housing

Adverse childhood experiences ACEs

• Traumatic events that occur during a person’s childhood 

  • Abuse, neglect, household dysfunction

  • Can also be a major disaster

• If left untreated, can impact more than just one individual

• Results in higher risk of chronic health conditions and mortality, also mental disorders and suicide risks

Practicing social justice as a PHN

• Broad holistic views of health

• Strong convictions about health care as a basic human right 

• Improving the health of communities is a societal responsibility 

Concepts of inclusion, participation, empowerment, recognition that diversity is a strength

Treat people fairly, regardless of where they live and who they are