Interview
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ABSTRACTS
Don McBeath is Director of Telemedicine for the Texas Tech University Health Sciences Center in Lubbock, Texas, and responsible for the operations of the Tech telemedicine network. Don is also responsible for rural health initiatives with community and regional leaders. He has a Bachelor of Arts degree from Texas Tech University and is an outstanding alumnus of the School of Mass Communications. Don is also a member of ATA and ATSP. LP: As President of the Texas Rural Health Association, you know the value of successful advocacy. Do you think there are areas of rural health care that are not getting enough public attention? If so, what are they? DM: I believe the general public, which resides in mostly urban areas, and the leadership of this state and country need to have a more complete understanding of the inadequacies of health care in many rural areas and the significance of that issue to them. In Texas alone, more than 80% of the population resides in urban and suburban areas - mostly in the eastern half of the state. So, does that mean that the 20% that live in rural areas should have lesser access to and lower levels of health care? I think not. Besides the moral implications, common sense, and "doing the right thing," there is the fact that the rural land mass and rural citizens are equally important to all of us. I am often amused by urbanites that live with little appreciation for where the gasoline in their car, the food on their table, and the clothes on their back came from. We should strive for more equalized access to health care in all regions of Texas. Author Affiliation
Abstract The Rural Economic and Community Health (REACH) project is a policy-oriented academic-state/regional-community partnership directed toward enhancing and evaluating the impact of rural development and community health policy on the health of individuals and communities. This article presents and illustrates the application of an innovative and integrative framework for addressing the role of community and economic development on rural health and health care disparities based on the REACH project. Key words: health policy, REACH, rural development, rural health. (Texas Journal of Rural Health 2002; 20(4): 5-17) Author Affiliation
Abstract Health care in the Lower Rio Grande Valley (LRGV) of Texas is unique due to the poverty in the area as well as the income disparity between people in the two nations. To explore the health care system, we held a seminar of local professionals working on their master's degrees in public health. An open academic seminar format was used in an attempt to avoid the biases inherent in traditional surveys where providers and patients have incentives to conceal their behavior. The seminar discussions revealed that the migration of patients across the border for care is greater than traditional surveys reveal, but that the exchange of information between health professionals on either side of the border providing care to them is minimal or non-existent in many cases. Key words: border health, Rio Grande Valley, rural health, Texas. (Texas Journal of Rural Health 2002; 20(4): 18-24) Author Affiliation
Abstract Secretary Tommy Thompson of the United States Department of Health and Human Services recently announced the availability of $46 million in funding to improve health care for rural residents. One of the department's new actions will include the use of geographic information systems (GIS) to identify the Health and Human Services' investments in specific communities and populations and to identify communities with unmet needs. This article describes how GIS can be used to identify racial and ethnic cancer disparities for selected cancers in rural counties in Texas and demonstrates its application in guiding the development of strategies for improving the distribution of cancer screening and treatment services in rural areas. Key words: cancer disparities, cancer screening, information systems, rural health. (Texas Journal of Rural Health 2002; 20(4): 25-34) Author Affiliation
Abstract This article presents an approach to health-centered rural policy, which is grounded in research on the social and economic determinants of population health. It reviews related strategies for sustaining and supporting rural communities through a fuller integration of rural development and health policy as well as selected state models for implementing a health-centered rural policy agenda. Key words: economic development, physical environment, rural policy, social environment. (Texas Journal of Rural Health 2002; 20(4): 35-43) Author Affiliation
Abstract The Rural Community Health System of Texas (RCHS) was developed by the Texas State Legislature to facilitate the organization of rural provider networks and the establishment of payment rules and insurance products for rural counties and communities. This article discusses the evolving role of the RCHS as a vehicle for enhancing rural economic development and access to services. Key words: economic development, insurance, managed care, RCHS, rural Texas, STAR program. (Texas Journal of Rural Health 2002; 20(4): 44-51) Author Affiliation
Abstract This article presents an approach to formulating sustainable development strategies in rural and related business communities. Key implications include the following: (1) economic development is not the same as sustainable development; (2) sustainable development requires that local needs, priorities, and resources be taken into account; (3) both small and large businesses may be important allies in promoting sustainable development; and (4) to forge and sustain these possibilities, businesses and the community must "profit" in both material and non-material ways from the resulting investments. Key words: economic development, planning models, rural communities, social capital, sustainability. (Texas Journal of Rural Health 2002; 20(4): 52-61) Author Affiliation
Abstract This article presents the policy, research, and design considerations in developing a prototypical statewide Internet-based information system to support integrated rural development and health planning activities. The article describes the conceptual framework, database parameters, analytic potential, and spatial display components of such a system. Key words: database parameters, Internet-based information system, research, rural economics. (Texas Journal of Rural Health 2002; 20(4): 62-70) Author Affiliation
Abstract This article describes and applies a methodology for carrying out a feasibility study for a long-term care facility in a rural environment and demonstrates the specific application of these methods in conducting a feasibility study in a frontier county, Morton, Cochran County, Texas. The article is intended to provide guidance for performing comparable long-term care feasibility studies in other rural counties and communities. Key words: Cochran County, long-term care, rural health, Texas. (Texas Journal of Rural Health 2002; 20(4): 71-83) Author Affiliation
Abstract The East Texas Area Health Education Center (AHEC), based at the University of Texas Medical Branch at Galveston, serves 111 counties of the state through eight community-based regional operations centers. Five centers have predominately rural populations. Over the past 11 years, East Texas AHEC has provided a variety of health workforce and community health systems support activities. These activities have engaged hundreds of community business and organizational partners, especially in the health sector. Programmatic efforts have involved thousands of citizens as participants or collaborators in community-oriented programs. It is from this experience that the following observations and perspectives are offered. Key words: community health, East Texas AHEC, rural policy, rural Texas. (Texas Journal of Rural Health 2002; 20(4): 84-87) Author Affiliation
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