2009 TFAH report, Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism
The issue of funding healthcare initiatives for state residents living in rural areas is certainly important and often overlooked. According to the Rural Assistance Center (RAC), which tracks public healthcare assistance and access for this historically underserved population, slightly less than half of all of the state of Alabama’s hospitals are in rural areas and federally qualified health centers also exist to provide services at 151 sites in rural locations. This suggests that proximity to healthcare facilities is less of an issue than it may be in other states (Alabama, 2010, RAC). However, the challenges of poverty still afflict Alabama residents. While the average per-capita income for all Alabama residents in 2007 was $32,419, the average rural per-capita income of a state resident was $27,754 (Alabama, 2010, RAC). 18.6% of residents in rural Alabama live below the poverty line compared with 14.8% of urban residents of the state (Alabama, 2010, RAC).
Education is also another important aspect of healthcare, given that health literacy is a vital component of public health improvement. Only with access to information will individuals take real, proactive steps to improve their lifestyles and seek appropriate preventative screening. But individuals may not have the appropriate educational background to understand health-related concepts and materials. And individuals from rural backgrounds are less likely to have an education in Alabama: 30.7% of the rural population does not have a high school diploma, versus 22.2% of individuals in urban locations. Finally, the unemployment rate in rural Alabama is 6.0% versus urban Alabama where it is 4.7%. 14.0% of Alabama residents lack health insurance of any kind (Kaiser, 2008-2009).
This data underlines the importance of tailoring health-related services to the needs of a specific population. Although Alabama’s rural population may not be as ‘spread out’ as it might be in the Midwest and clinics and other points of health access are available, there is still a need for expanded healthcare education. The poverty of rural areas and the lack of health insurance of many residents also underline the need for continued funding for healthcare initiatives to support individuals without adequate financial access to health resources.
Alabama. (2010, October 10). Rural Assistance Center, (RAC). Retrieved November 2, 2010 at http://www.raconline.org/states/alabama.php
D2: The importance of food and proper nutrition has become of renewed interest in the public consciousnesses. Everybody eats — on a daily basis — and the food choices people make have a substantial impact upon their state of health and wellness. Food safety has also become of increased concern, because of the recalls of popular products spanning the range from peanut butter to pistachios to hamburger meat. Being able to recognize the signs of dietary distress due to food-transmitted illnesses is indeed important — but so is making proactive and positive choices about what one eats. The obesity crisis is, I believe, even more important than problems surrounding food safety-borne epidemics. Despite the recent attention given to obesity in the popular media, obesity is in some ways more difficult to treat than food safety issues. People’s consciousness may be raised by a fear if becoming sick through food poisoning and throw out the offending, recalled products on their shelves if they contain salmonella or e.coli, but they seem less willing and/or able to change food habits that have been ingrained within them since childhood.
The diabetes epidemic, along with other illnesses related to obesity (like heart disease, high cholesterol, high blood pressure, and osteoarthritis) will increase unless more active preventative healthcare measures are undertaken on a wide scale. Limiting the number of fast food restaurants that can be present in a specific area and near schools, along with promoting the spread of grocery stores and farmer’s markets in ‘food deserts’ can increase is an important first step. So is taxing soda and prohibiting the use of food stamps to buy sugary soft.
Changes in legislation are needed, I believe, to fully address the causes of diabetes. However, until then, individuals must learn to take proactive steps to protect their own health. Nurses and other healthcare professionals must recognize when clients’ illnesses are not simply due to personal choices, but are the result of a lifetime of health behaviors facilitated by their environments. It is mistaken to think that telling someone ‘you need to lose weight by moving more and eating less’ is enough. Although this is a very simple statement to make, the question of how to achieve such objectives must be the result of a dialogue between healthcare professionals and the patient.
When the question as to why the individual does not move more arises, the issue must be made specific: is it a lack of safe places to exercise? Is it time? Quite often, poorer individuals working multiple jobs do not have the ability to engage in effective physical activity without proper planning and assistance from someone else who can show them to how to work exercise into their lives. Budgeting for healthy food that is tasty and satisfying, and cooking it with limited access to time and facilities can also be challenging in the absence of professional support and advice (Engber 2009, p.1).
Changing lifestyles is a vital aspect of making the community healthier — as well as the world. Sanitary and healthy cooking conditions are, of course, extremely important to observe and to know about, on an individual basis. Increasing the ease of reporting suspected unsafe conditions is also vitally important. But the relative safety of day-in, day-out food choices — food choices that are often taken for granted — also cannot be dismissed.
Engber, Daniel (2009). Does poverty make people poor? Slate. Retrieved November 2, 2010 at http://www.slate.com/id/2229523/
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