Notes From the Field
Policy and Law
Scott Peters is an Assistant Professor in the Department of Education at Cornell University. His teaching and extension work at Cornell focus on civic renewal, community education and development, youth development, and public issues education. His research is devoted to exploring the historical foundations, evolution, and contemporary renewal of cooperative extension's civic mission and public work tradition, and their connection to the democratic promise of the land-grant idea in American higher education. He is currently at work on three books that relate to this theme: a history of the founding and early development of the cooperative extension movement, a Liberty Hyde Bailey Reader, and a set of contemporary case studies that relate to the theory and practice of public scholarship at land-grant colleges and universities.
Dr. Peters is a Consulting Editor for two journals, the Adult Education Quarterly and the Higher Education Exchange as well as a senior associate with the University of Minnesota's Center for Democracy and Citizenship. He holds a B.S. in Education from the University of Illinois at Urbana-Champaign (1983), an M.A. in Public Affairs from the University of Minnesota's Humphrey Institute of Public Affairs (1995), and a Ph.D. in Educational Policy and Administration, also from the University of Minnesota (1998). From 1984 to 1993 he served as Program Director of the University YMCA at the University of Illinois. His book, The Promise of Association, published in 1998, chronicles the history of the civic mission and work of the University YMCA for its 125th anniversary. He plans to continue his research on the YMCA by writing a history of the student YMCA movement as a whole.
LP: What role does scholarly research play in the development of rural communities?
SP: Scholarly research can and does play a variety of roles. While people often view scholars as technicians who "crunch the numbers" and produce a set of statistics related to demographics or economic trends (which is often an important role), they can also play an important part in helping a community deliberate about what their hopes and problems are and what to do about them. So, on the one hand a scholar might contribute to the development of health care policy in a rural community through survey research that generates local statistics or by bringing national statistics to bear on the local problem. Or on the other hand, a scholar might contribute by helping people to learn how to better understand just what the local problem is that needs to be addressed, how various players in the community understand the problem, and how to bring people together to generate good ideas for acting on it. This kind of research, which is often called "action research," is about helping people to think more critically about what they really want, while involving them in creating the knowledge they need to take effective action. It's not just about meeting an economic bottom line by dealing with isolated parts of a larger whole. Scholars have a responsibility to help people think more broadly about the public interest as well as to focus on specific details such as like demographic statistics. Number crunching is important, of course, but a scholar's role and responsibility can and should extend beyond the numbers.
The education of our youth should begin as early as six months of age. Children and their parents must be immunized against the heartbreak of illiteracy. The ROR (Reach Out and Read) program is a functional method for confronting the growing problem of illiteracy within our nation. This article discusses a primary care provider setting's attempt to establish a program to address this identified concern. The article provides some of the challenges and successes encountered during the process. The ideas presented here can be used to help address the unique illiteracy problems confronting every community.
Key words: children, illiteracy, Reach Out and Read, reading, volunteers. (Texas Journal of Rural Health 2002; 20(1): 12-16)
(This article appeared without an abstract)
Why a new state agency? This is a tough question in a time of tight budget dollars and a focus on leaner government. It is also one that can be responsibly addressed.
The rural hospital in Hale Center, Texas has just closed. Voters in Linden, Texas, rejected the idea of a hospital district in a recent election. The number of rural health clinics has decreased by about 40% in the past three or four years. Many practicing physicians in rural communities are nearing retirement age and have no new physician that wants to take over their practices. Meanwhile, the population in rural Texas continues to age, increasing the need for medical care. These are frightening trends, particularly in light of many federal and state health care initiatives and in spite of numerous programs aimed at "fixing" the problem. Something is evidently not working well enough.
The dengue virus is transmitted by two Aedes species of mosquito. Both are present in the United States and Mexico. The presence of these vectors causes concern that the dengue pathogen is spreading into the United States across the Texas/Mexico border. Outbreaks have occurred in South Texas since 1980. Yet, Texas has not experienced a dengue epidemic, although Mexico has. An epidemic in Texas is possible in the near future. This article focuses on an anthropological approach to the viral infection and spread of dengue. It suggests that human behavior, monetary status, culture, and education all appear to contribute to a high risk of exposure to dengue fever virus among the Mexican-American populations in the Brownsville, Texas area.
Key words: dengue fever, infectious disease, medical anthropology, Mexican border, public health, Texas. (Texas Journal of Rural Health 2002; 20(1): 20-33)
The purpose of this study is to investigate the relationship between rural residence, the presence of co-morbidities, income, and Hispanic ethnicity with the risk of being a high-user of medical visits. Respondents to the National Health Interview Survey (1997) who reported having heart disease and being age 65 or over were selected for analysis. Logistic regression in SUDAAN was used for the multivariate analysis. Rural residence was marginally significant in univariate analysis, but non-significant in multivariate analysis. Being low-income and Hispanic were not associated with being a high-user in this population. Poor health, asthma, cancer, and liver disease increased the odds of being a high-user. The odds ratios were 1.93, 1.42, and 2.15 for asthma, cancer, and liver disease, respectively. Among elderly heart disease patients, the odds of being a high-user are greater if one is in poor health. Social and economic variables proved not to be significant when health status and co-morbid conditions were taken into account.
Key words: elderly patients, heart disease, medical visits, rural health. (Texas Journal of Rural Health 2002; 20(1): 34-43)
Before the first confirmed case of inhalational anthrax caused by the intentional release of Bacillus anthracis on October 4, 2001, the disease had not been of great concern to the American public. However, once the media began in-depth coverage of this act of bioterrorism, the public was immediately thrown into a frenzy of fear and confusion. Hoaxes and misinformation only added to this panic. Public health officials suddenly found themselves under intense scrutiny, and tough questions were asked about disease control and prevention. Sometimes the answers were not what people wanted to hear.
However, the disease control and prevention problems facing public health officials are nothing new, nor are they going to disappear any time soon. They have only been brought to better light because of the recent outbreak. With the media hype rapidly fading, so too has the public attention on these problems. As the biological bogeyman disappears out of the public eye, will anything change as a result of this tragedy or will it be forgotten as quickly as an old nightmare?
This article briefly examines the ramifications of the 2001 anthrax outbreak with regard to disease control and prevention in rural health. In addition, the effect this event has had on the Texas Department of Health will be discussed. An overview of anthrax and bioterrorism will also be addressed.
Key words: agriculture, anthrax, bioterrorism, disease control & prevention, epidemiology, rural health providers, Texas Department of Health. (Texas Journal of Rural Health 2002; 20(1): 44-56)
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