Oral

This session highlights pivotal areas of inquiry in rural health. Are rural people getting equitable access to care? How can we help rural people take better care of themselves and make better use of the resources available to them? Will surgery continue to be available in rural communities? Arthritis and diabetes are extremely common chronic diseases. Wallace and Young-Xu find, reviewing national data bases, that diagnoses of knee arthritis are twice as common among rural as urban outpatients, yet the likelihood of rural patients receiving knee arthroplasty is only about half that of urban patients. Correlating variables are analyzed. Raffle et. al. find elevated rates of diabetes in a telephone survey of households in rural Appalachian counties of southern Ohio. Patient-reported affective status - depressed mood - was found to be one of the most important determinants of diabetic patients’ effective self management, confirming the need to link traditional and behavioral health services. Drs. Simmons and Huddleston-Casas retrospectively analyze interview data from a three year study of over four hundred rural families with incomes below 250% the poverty level. They find that health concerns are of low priority in these families, often leading to neglect of both prevention and treatment. The authors show how a collaborative strategic approach between client and provider, “Personalized Health Planning”, might make it possible for these families to to manage their health issues more effectively, given the resources available to them. Crilly et. al. study access to & use of the internet for health purposes by households in the central south census region as sampled by phone in 2007. Rural internet users were three times as likely as urban to depend on dial up service, and seem particularly likely to use the net for health information and to access support groups. Surgery is disproportionately important to rural communities for two main reasons. Trauma of several kinds is disproportionately common, and surgery subsidizes underfunded primary care. Poley et al report the demographics of in- and out-migration of surgeons in rural America between 2006 and 2009, a critical starting point for planning.

Session Objectives: 1. Describe three ways that Personalized Health Planning may help poor families organize their health management. 2. Describe the disparity between rural and urban populations in the treatment of one common chronic condition, arthritis of the knee. 3. Identify which surgeons are more likely to leave and which to remain in rural practices.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)