259548 Healthcare in very rural and frontier communities: Balancing equity, effectiveness and efficiency

Wednesday, October 31, 2012 : 12:30 PM - 12:50 PM

Susan Wilger, BS, MPAff , National Center for Frontier Communities, Silver City, NM
The National Center for Frontier Communities in partnership with State Offices of Rural Health have designated close to four percent of the nation's population as remote rural communities or “frontier”. Ten million frontier residents are scattered across 56% percent of the land area of the United States.

Healthcare access and services in very rural and frontier communities are very different from delivery systems in “rural” and urban centers. Residents of very rural and frontier communities are typically older, poorer and more likely to be uninsured. These communities suffer the most severe health care provider shortages in the country. Very rural economies are often based on limited resources or activities and are more at risk of economic downturns and boom-bust cycles--such as farming, ranching, tourism, logging, and mining—and they may be more vulnerable to less desirable sources of business income, such as nuclear waste disposal. These communities often lack any form of public transportation and are located in food deserts.

The National Center for Frontier Communities in partnership with the national Frontier and Rural Expert Panel have examined five evidence-based healthcare models that provide effective and cost-efficient care for frontier and remote rural communities. These programs include: Community Health Worker based care coordination, mental health aides, dental aides, community health aides and Frontier Extended Stay Clinics. Participants will learn about the key program components, education and training requirements, funding/sustainability issues, regulatory factors, and policy issues relating to each of the five models.

Learning Areas:
Administer health education strategies, interventions and programs
Diversity and culture
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Participants will be able to: 1. Name five evidence-based model programs that have shown to be effective in very rural and frontier communities. 2. Identify state policy issues that hinder or promote the model programs at the local, state or federal levels. 3.Discuss policy strategies that can promote community-based services in very rural and frontier areas.

Keywords: Community-Based Health Care, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Wilger has 25 years experience as a program developer, director, advocate and planner in the fields of behavioral and primary health care, child care, prevention and domestic violence services. Wilger co-facilitates the Frontier and Rural Expert Panel and the Frontier Constituency Group of the National Rural Health Association. Wilger received her Bachelors Degree from the University of Wisconsin at Madison and a Masters Degree in Public Affairs from the University of Texas at Austin.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.