Rural Public Health Services in a Time of Immigration: Challenges faced by local public health services

As many of the rural areas in Pennsylvania lose population as young people leave the region, waves of immigrants are replacing this population. Foreign born individuals and households that speak a language other than English have increased by one to two percentage points in non-urban areas of Pennsylvania. All of these areas are not served by a local health department, but instead are served by small state clinics. However, with an average staff of less than three, these clinics lack the human resources with the necessary training to address the health and health care needs of this increasing immigrant population.

The purpose of this paper is to identify gaps in the training of the public health workforce so that training programs addressing these gaps can be developed by regional academic public health programs.

The paper surveyed 57 rural counties in Pennsylvania with a self-administered web-based survey. The 15 counties with the highest number of foreign born residents were administered face-to-face surveys. Both surveys collected data on the barriers faced by immigrants in accessing health and health care services, and on the ability of the clinic staff to serve these clients. Preliminary data shows that immigrants face broader barriers across the socio-ecological model than non-immigrant clients, including but not limited to: language; housing; stabled schooling; and employment. The preliminary results show that those serving immigrant populations have to understand post-immigrant social and economic factors as well as specific biological determinants of health