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Interview
Notes From The Field
Policy and Law
Research
Review
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ABSTRACTS
Brad Gibbens, M.P.A., is the Associate Director of the University of North Dakota (UND) Center for Rural Health, UND School of Medicine and Health Sciences. Mr. Gibbens is also an assistant professor at the medical school. The center is one of the oldest state rural health offices in the country. It was formed in 1980 by the North Dakota legislature and the medical school. Mr. Gibbens serves as the Director of the State Office of Rural Health (SORH) and is the Chair of the North Dakota Medicare Rural Hospital Flexibility Steering Committee. The "Flex" grant is administered by the center. Mr. Gibbens has worked in rural health, at the center, for 15 years. During that time he has concentrated on health policy, community development, and grant development activities. He served for seven years on the National Organization of State Offices of Rural Health (NOSORH) Board of Directors. He received the NOSORH Award for Distinguished Service in 1999. Mr. Gibbens is also an active member of the National Rural Health Association (NRHA). He has both his undergraduate and graduate degrees from UND. He is a native North Dakotan, growing up on a durum wheat farm near Cando, North Dakota. LP: What are the health care challenges that face rural communities in North Dakota? BG: There are many challenges, even threats facing rural communities in North Dakota. Some are directly tied to health issues (e.g., access to services, maintaining viable local/area health systems, provider reimbursement, workforce supply, and physical plant needs), but a couple are more pervasive. They impact the community as a whole be it the school system, down-town business, local government, religious community, or local/area health system. I am referring to demographics and economics and will direct my remarks to them. Author Affiliations
Abstract The prevalence of overweight children was documented at a rural school-based clinic. Body mass index was calculated using height and weight records in 67% of the school population during the 1998 to 1999 school year. Overall, 20% of the females and 18% of the males were classified at risk of becoming overweight (BMI >85th-95th percentile), while 22% of the females and 19% of the males were classified as overweight and at risk for obesity (BMI >95th percentile). Key words: body mass index, rural schools, overweight children. (Texas Journal of Rural Health 2001; 19(2): 16-21) Author Affiliations
Abstract When the community of Pearl, Mississippi experienced a school shooting, local religious leaders were among the first to respond. Clergy and youth ministers were integrally involved in the counseling organized by the Pearl Public School District. The role of religious leaders in disaster response efforts is discussed within the context of general disaster response philosophy as well as within the context of the Mississippi culture. The local faith community was observed to play an important role in holistic recovery efforts, and enhanced the impact of the school staff and mental health professionals in this regard. Key words: clergy, mental health, Mississippi, psychological counseling, rural, school shooting, trauma recovery. (Texas Journal of Rural Health 2001; 19(2): 22-29) Author Affiliations
Abstract The purpose of this investigation is two-fold: (1) to report on the efficacy of an innovative domestic violence training program for migrant farm worker women; and (2) to present findings from data gathered during a two-year period by the trained migrant farm worker advocates. The data provide strong evidence for the effectiveness of the training program. Using standardized interview forms, the trained advocates collected domestic violence data from 502 migrant farm worker women. The reported rate of physical and/or sexual abuse was 50%. Alcohol use by intimate partners significantly increased the risk for women of experiencing physical, sexual, and emotional abuse. Key words: domestic violence, migrant farm workers, rural health, women. (Texas Journal of Rural Health 2001; 19(2): 30-41) Author Affiliations
Abstract The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) (Pub. L. 104-193), as amended, is the welfare reform law that established the Temporary Assistance for Needy Families (TANF) program. The policy implications of the legislation have the potential to directly affect the health of this already at-risk population. Much like public health specialists, researchers, and policy advocates, nurses need to monitor the effects of welfare reform on the health of these vulnerable individuals and families. Key words: health policy, low-income reform, TANF, welfare reform. (Texas Journal of Rural Health 2001; 19(2): 42-48) Author Affiliations
Abstract The premature mortality rate is associated with poverty rates in the Panhandle region of Texas. In contrast, the age-adjusted mortality rate is not related to poverty rates, population density, ethnicity, or the supply of primary care physicians. In addition, it is above national standards. Poverty rates are higher in rural counties, the supply of primary care physicians is lower, and proportions of Blacks and Hispanics are lower. Key words: mortality rate, Panhandle, population density, poverty rates, rural counties, rural health, Texas. (Texas Journal of Rural Health 2001; 19(2): 49-60) Author Affiliations
Abstract In May 1993, a mysterious pulmonary illness broke out in the"Four Corners," an area of the Southwest shared by New Mexico, Arizona, Colorado, and Utah. Half of the young, and formally healthy, people infected would soon die of acute respiratory failure. The Centers for Disease Control and Prevention (CDC), the Indian Health Services (IHS), and four State Departments of Health (Arizona, Colorado, New Mexico, and Utah) began an in-depth investigation, with the assistance of the Navajo Nation Division of Health. By November 1993, a new hantavirus, Sin nombre virus (SNV), was isolated, and the disease it caused was named hantavirus pulmonary syndrome (HPS). The main host of SNV was discovered to be the deer mouse (Peromyscus maniculatus). Since 1993, HPS has been found throughout the United States as well as several other countries, defining it as a pan-American disease. Researchers have also discovered that there are several hantaviruses that can cause HPS as well as other hosts. With an increased risk of exposure to infected animals in rural areas, HPS can be a real concern for rural citizens. Diagnosis and supportive treatment must be conducted quickly to avoid mortality, thus exemplifying the need for better understanding of this rare, but deadly, disease. This article reviews HPS in detail, discussing its background and the most recent updates. Key words: disease control, Four Corners, hantavirus, hantavirus pulmonary syndrome, HPS, rural, Sin nombre virus. (Texas Journal of Rural Health 2001; 19(2): 61-77) Author Affiliations
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