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Building on Communities’ Strengths to Achieve Better Health and Well-Being in Rural Georgia

Tanisa Foxworth Adimu

Tanisa Foxworth Adimu, Assistant Project Director, Georgia Health Policy Center

By Tanisa Foxworth Adimu

About 60 million people living in the United States live in rural communities, with nearly 1.8 million living in rural Georgia, according to the 2010 census.

Rural America is not monolithic and includes a wide variety of locales, from densely populated small towns to neighborhoods on the border of urban areas to more sparsely populated communities. In Georgia, 108 of the state’s 159 counties are considered rural.

Rural communities in Georgia experience several population health trends that present barriers to achieving health and well-being. Compared to urban areas and the nation as a whole, rural communities have higher rates of unintentional deaths and chronic conditions, fewer primary and specialty care providers, lower rates of insurance coverage and educational attainment. They have less access to broadband technology, lower median household incomes and often a built-environment (such as sidewalks and parks) lacking safe places for physical activity and affordable healthy foods.

These trends contribute to poorer health outcomes in rural Georgia, creating opportunities for businesses, nonprofits and health systems to intervene in ways that improve care, enhance quality of life and decrease costs. But for every troubling trend persistent in rural communities, there are emerging innovations. These innovations build on the strengths, assets and resiliency present in rural communities and rely upon partnerships among health care providers and those in business, education, technology and community development sectors.

The Georgia Health Policy Center (GHPC) has expertise in helping rural communities improve health and health care delivery in an effective and sustainable manner. The center also has experience in helping policymakers, providers and funders understand the unique challenges and opportunities in rural communities. GHPC created the Making Connections series as a supplement to its Understanding the Rural Landscape learning module.

This series explores the range of elements that influence rural health, with special emphasis on the unique challenges and innovative solutions emerging in rural communities. Rural community leaders across the country are implementing innovative strategies to address health and health care challenges, such as the following:

Access to health care in rural communities is a complex issue that is affected by different factors, including a shortage of primary and specialty care providers practicing in rural areas, distance to services, and insurance coverage. The access issue is further compounded by the growing epidemic of rural hospital closures. Yet, across the nation there are examples of communities reimaging what a rural hospital looks like. Many rural hospitals are evolving from inpatient models of care to new models, including freestanding emergency and urgent care facilities, outpatient centers and “hub-and-spoke” models that integrate small and large providers into one connected system.

Economic stability is one of the primary social determinants of health and can be viewed as a root cause of illness and a driver of access to care. Rural areas have lagged behind metropolitan areas in job growth, employment rates and median household income, but there are examples of innovation in which rural communities are able to draw upon abundant natural resources to strengthen the local workforce. For example, solar farms in Georgia and wind farms in the West and Midwest are providing rural residents new economic opportunities.

Technology infrastructure is expensive to build in rural communities, with 25 percent of Georgia residents lacking access to quality and dependable Internet access. But innovations, like the STEMMOBILE in rural Tennessee, enables a technology-driven learning experience for students in grades pre-kindergarten to 8th grade. The STEMmobile is equipped with self-contained power, satellite Internet connectivity, iPads, laptops and other technology tools. This brings needed technology infrastructure, as well a boost to educational opportunity to rural communities.

Educational attainment affects not only earning potential, but also quality of life. Rural education levels are improving, but by leveraging national policy opportunities, like those in the Every Student Succeeds Act and the Rural Education Achievement Program, rural school districts can access additional resources to purchase technology and staff training.

Schools in rural areas can also serve as a community gathering place and a place for physical activity. In Blackville S.C., a local community healthy eating and active living coalition worked with the local school district to adopt an Open Community Use Policy, allowing community members to use school grounds outside school hours.

The factors that affect rural health and well-being are complex and interrelated. Much of what influences health happens outside of traditional care settings. Effective solutions will require partnerships between Georgia’s health, business, education and civic leaders.

Tanisa Foxworth Adimu is an assistant project director at the Andrew Young School of Policy Studies at Georgia State University. She co-developed the center’s Understanding the Rural Landscape learning module, as well as the supplementary Making Connections series with the Community Health Systems Development team.

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