Where you live can have a profound effect on your health and there is growing recognition that geographic location, specifically rural residence, can lead to significant disparities in health care access and quality.
Rural residents have increased rates of chronic disease and mortality compared to people who live in urban areas. A number of issues contribute to rural health disparities, including higher rates of poverty, a shortage of health care professionals and long travel distances to receive care. The U.S. Department of Health and Human Services has designated rural residents as one of seven “priority populations” with unique health care needs that require special attention.
College of Public Health and Health Professions faculty members are leading several projects that use innovative approaches to bring health services to rural residents. For example, we have conducted weight management studies in rural areas in conjunction with staff of the U.S. Department of Agriculture’s Cooperative Extension Service, an educational network with offices in every U.S. county. The Cooperative Extension Service is considered a well-respected resource by rural residents and extension offices provide a convenient physical location for participant meetings. Dr. David Janicke has partnered with the Cooperative Extension Service to evaluate the effectiveness of family lifestyle intervention programs to improve nutrition and fitness among preschool and elementary aged children living in rural settings.
We have also used phone-based counseling for long-term maintenance of weight loss with great success. This is a particularly cost-effective, accessible approach for rural residents. The college’s Center for Research on Telehealth and Assistive Technology, led by Dr. William Mann, has developed programs to deliver care across distances, such as AlzOnline, a website with information for caregivers of people with Alzheimer’s disease.
The center works closely with the North Florida/South Georgia Veterans Administration, which, under the direction of Dr. Charles Levy, chief of physical medicine and rehabilitation, developed the Rural Veterans Tele-Rehabilitation Initiative. The initiative employs secure web technologies to provide rehabilitation services for veterans in rural areas. The center is also working with the Veterans Health Administration to update technology in the Gator-Tech Smart House using a smart home system developed at the VA’s polytrauma unit in Tampa.
The college’s Institute for Mobility, Activity and Participation (I-MAP), directed by Dr. Sherrilene Classen, brings driving assessment and intervention services to rural residents in the form of a specially-designed mobile driving simulator housed in the back of a Dodge van. In collaboration with the North Florida/South Georgia Veterans Administration, I-MAP driving rehabilitation specialists conduct driving assessments and behind-the-wheel training with veterans living in rural north Florida who have limited access to I-MAP’s on-campus research facilities.
The Rural South Public Health Training Center, led by Dr. Mary Peoples-Sheps, is developing workforce education programs for rural public health workers. The National Rural Behavioral Health Center focuses on rural behavioral health service delivery, violence prevention and disaster recovery under the direction of Dr. Brenda Wiens. For more information on these college centers, please see the story on the Morrill Act on pages 2-3.
About 59 million people live in rural areas, yet there have traditionally been few studies devoted to their health concerns. With these projects and others, the College of Public Health and Health Professions is working to address rural residents’ needs and develop interventions tailored to the unique challenges of rural communities.