Rebuilding The Unity Of Health And The Environment In Rural America

Throughout much of its history, the United States was predominantly a rural society. The need to provide sustenance resulted in many people settling in areas where food could be raised for their families. Over the past century, however, a quiet shift from a rural to an urban society occurred, such that by 1920, for the first time, more members of our society lived in urban regions than in rural ones. This was made possible by changing agricultural practices. No longer must individuals raise their own food, and the number of person-hours and acreage required to produce food has steadily been decreasing because of technological advances, according to Roundtable member James Merchant of the University of Iowa. The Institute of Medicine's Roundtable on Environmental Health Science, Research, and Medicine held a regional workshop at the University of Iowa on November 29 and 30, 2004, to look at rural environmental health issues. Iowa, with its expanse of rural land area, growing agribusiness, aging population, and increasing immigrant population, provided an opportunity to explore environmental health in a region of the country that is not as densely populated. As many workshop participants agreed, the shifting agricultural practices as the country progresses from family operations to large-scale corporate farms will have impacts on environmental health. This report describes and summarizes the participants' presentations to the Roundtable members and the discussions that the members had with the presenters and participants at the workshop.

This is a summary of the workshop Rebuilding the Unity of Health and the Environment: A New Vision of Environmental Health for the 21st Century. The goal of this workshop was to emphasize the connection between human health and the natural, built, and social environments. This workshop integrated talks from many fields and created a dialogue among various environmental health stakeholders. The language presented in this respect should not be viewed as an endorsement by the Environmental Health Sciences Roundtable or the Institute of Medicine of what action is needed for the future, but rather as an effort to synthesize the various perspectives presented.

The purpose of this regional workshop in the Southeast was to broaden the environmental health perspective from its typical focus on environmental toxicology to a view that included the impact of the natural, built, and social environments on human health. Early in the planning, Roundtable members realized that the process of engaging speakers and developing an agenda for the workshop would be nearly as instructive as the workshop itself. In their efforts to encourage a wide scope of participation, Roundtable members sought input from individuals from a broad range of diverse fields-urban planners, transportation engineers, landscape architects, developers, clergy, local elected officials, heads of industry, and others. This workshop summary captures the discussions that occurred during the two-day meeting. During this workshop, four main themes were explored: (1) environmental and individual health are intrinsically intertwined; (2) traditional methods of ensuring environmental health protection, such as regulations, should be balanced by more cooperative approaches to problem solving; (3) environmental health efforts should be holistic and interdisciplinary; and (4) technological advances, along with coordinated action across educational, business, social, and political spheres, offer great hope for protecting environmental health. This workshop report is an informational document that provides a summary of the regional meeting.

Foundations of Rural Public Health in America spans a wide variety of important issues affecting rural public health, including consumer and family health, environmental and occupational health, mental health, substance abuse, disease prevention and control, rural health care delivery systems, and health disparities. Divided into five sections, the book covers understanding rural communities, public health systems and policies for rural communities, health disparities in rural communities and among special populations, and advancing rural health including assessment, planning and intervention. Written by a multidisciplinary team of experienced scholars and practitioners, this authoritative text comprehensively covers rural health issues today.

"This book describes the population health concerns of small-town America and how these concerns are affected by the unique characteristics of these places focusing on the built environment"--

This innovative resource offers a unique, multidisciplinary approach for the utilization of planning theory to eliminate health disparities in rural communities. The book provides tools in the public health, policy, and planning disciplines to help resolve significant differences in life expectancy and quality of life in these communities, concluding with a progressive vision for alleviating geographical health disparities on a local, national, and global scale. Chapters highlight models and approaches best suited to addressing this public health concern, suggesting action strategies focused around each of the three focus areas: 1. Public health: Elucidation of the contextual factors impacting the health of rural communities by: reporting statistical updates on a range of chronic and infectious diseases that disproportionately affect rural populations both globally and in the U.S.; providing discourse on the importance of addressing critical social determinants (global and national) that impede optimal health outcomes among rural populations; and, acknowledging the compositional factors of individuals who reside in rural spaces. 2. Public policy: Application of specific policy models to garner both public and political will towards sustainable policy change to improve healthy living in rural spaces. 3. Rural planning: Identification of national and international planning models that can be used to design strategic plans targeted to improve quality of life, create sustainable development, and establish economic well-being and growth in rural communities. Rural Health Disparities: Public Health, Policy, and Planning Approaches will find an engaged audience among non-profit organizations, planners, public health practitioners, policy analysts, and public interest groups, as well as rural health advocates and students enrolled in planning, public policy, and/or public health courses.

Offers vivid narratives illuminating the challenges and opportunities health professionals and policymakers face Distinguished by abundant patient and health provider narratives highlighting the impact of health disparities on health outcomes worldwide, this scholarly yet practical text prepares RN-BSN, DNP, and PhD students to work toward improving community health for a variety of underserved and vulnerable populations. Grounded in the population health approach addressed in AACN Essentials, the text delivers practical steps nurses can take to address population health goals, including the improvement of quality of care, access to healthcare, improved outcomes, and cost management. The resource is also unique in its reflection of the interconnected points of view of the patient, the provider, and the health system. Written by lawyers, physicians, social workers, statisticians and economists, psychologists, ethicists, finance experts, population health specialists, anthropologists, and nurses, the text emphasizes an interdisciplinary approach to learning and all components of health care—delivery of care, policy, research, and teaching. It examines demographic differences, chronic and acute health conditions, and the health needs of the unserved/underserved across the life cycle. The book emphasizes the importance of understanding the social determinants of health and discusses ways to address health disparities through changes in public policy, attitudes, beliefs, education, research, and advocacy. Objectives, key terms, discussion questions, and exercises facilitate group discussion about best practices. Key Features: Delivers practical knowledge with detailed narratives and case studies of specific populations from experienced interprofessional authors Highlights the interwoven perspectives of patients, health providers, and health systems to promote cultural competence Pinpoints health disparities including a discussion of COVID-19 Presents selected historical landmarks and cases that influence population health outcomes among vulnerable groups Interdisciplinary approach includes the perspectives of other health and social science disciplines

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.

Ethics in Rural Psychology provides readers with theoretical underpinnings, practical applications, and empirically based knowledge of the practice of psychology in rural communities. Dr. Boilen explores the similarities and differences within and across rural American communities to provide a framework for understanding this vast and varied population. Focusing on the ethical considerations unique to these communities, chapters use illustrative case examples, useful exercises, and personal anecdotes to highlight obstacles unique to rural areas. Finally, the book emphasizes the opportunity to be innovative and creative in rural practice, demonstrating how rural practices hold promise for cutting-edge advancements in the field of psychology. This book will serve practitioners, students, and researchers as a primer, handbook, and road map for the challenging and rewarding clinical work that awaits in rural America.