Urban and Rural Health Considerations Flashcards
1
Q
What is an Under-Resourced Urban Community
A
- Areas within an urban setting that historically have not had proper resources to help community members thrive and maintain good health.
- You will see on BL there is a zoom link to speaker for class and her work. Need to watch with this lecture for test
2
Q
Social Determinants of Health (SDOH) that Influence Health Outcomes for People Living in Urban Communities: Economic Stability
A
- Redlining and the long-term effects have made building intergenerational wealth difficult impacts the urban communities
- Housing status
o What type of housing to people live in? safe? Maintained well? - Poverty
- Low-paying jobs that are stressful
- Lack of employment programs, career counseling, and high-quality child-care opportunities
3
Q
SDOH that Influence Health Outcomes for People Living in Urban Communities: Education Access and Quality
A
- Under-resourced schools
o Preclass videos: more property taxes, the more money that foes into schools. That will attract people to the communities. The more resourced a community in, the more resourced a school is - Children from low-income families are less likely to graduate from high school or go to college
- Stress of living in poverty can affect brain development
4
Q
SDOH that Influence Health Outcomes for People Living in Urban Communities: Health Care Access and Quality
A
- Lack of primary prevention services:
o Gyms
o Trails, parks, trees, and green spaces
o Nutritious food options - Structural and historic racism in health care affects trust
o If someone isn’t trusting the HC system based on prior experiences, that will affect if they WANT to access HC even if it is available - ACA and Medicaid expansion played a role in increasing rates of health insurance coverage
o However, just because someone may HAVE insurance and their might be a clinic nearby, they may not want to access it because of prior experience they or someone else has had
5
Q
SDOH that Influence Health Outcomes for People Living in Urban Communities: Neighborhood and Built Environment
A
- Violence
- Unsafe air or water
- Increased heat lots of concrete and parking lots increases the HEAT. Temperature in the neighborhood is higher. Green spaces will ‘absorb’ the heat in a way.
- Unhoused residents
- Illegal Dumping
6
Q
SDOH that Influence Health Outcomes for People Living in Urban Communities: Social and Community Context
A
- Discrimination
- Racism
- Violence causes stressful situations
- Intergenerational trauma Dr warren: working with people who have been affected bu this. WATCH
- Mass incarceration and long-term effects
o Adverse childhood events (ACE), but does not tell the intensity of what the person experienced the event, how often
7
Q
How has structural racism affected health disparities for people living in urban communities?
A
- Redlining WATCH THE VIDEOS
o Intergenerational poverty people cannot develop wealth
o Decreased access to nutritious food options
o Lack of parks, trees, green spaces, trails
o Under-resourced schools
o Under-resourced health care
All of these are effects of the racist practice of redlining - Intergenerational substance use
o Dr warren: air force base is closed in community; many people were left unemployed and started dealing drugs. This created lots of substance abuse in the areas - Aggressive policing
- Mass Incarceration and War on Drugs (Beginning in the 1970s)
o 70s: war on drugs began it really impacted black/brown communities Moreso than white.
o EX: people with crack cocaine were incarcerated more than powder cocaine (powder: more expensive, seen more in white affluent communities. Crack is cheaper and smoked, seen more in black communities) This caused rates of people being incarcerated at much higher rates (mass incarceration) in certain communities. This carries over through generations - Intergenerational trauma
- Adverse childhood experiences
8
Q
Health Disparities for Under-resourced Urban Communities
A
- Formerly redlined neighborhoods have higher prevalence of:
o cancer,
o asthma,
o COPD,
o diabetes,
o hypertension,
o hyperlipidemia,
o kidney disease,
o poor mental health, and
o people without health insurance than nonredlined neighborhoods.
o They also have a lower life expectancy.
(formally) Redlined areas the life expectancy is 10 years less than west Omaha today
9
Q
Identify Potential Solutions to Decrease Health Disparities in Urban Areas.
A
- Programs addressing SDOH:
o School curriculum
o After school programs
o Community centers and programs
o Want to address intergenerational trauma and ACEs
What happened to you? Not “what’s wrong with you”
o School tutoring
o Career counseling
o Child-care needs
o Community health advocates (Creighton)
o People know youre genuine when you lead with love – Dr. Warren (this also helps put yourself equally with others) - Policies addressing SDOH: getting laws involved!
o Safe housing policies
o Safe policing
o Access to safe air and water
o More green spaces, parks, gardens, trees, trails
o Unhoused residents
o Abolish dumping
o Minimum wage and income earn a living wage
o Health care coverage
o Equitable lending policies
10
Q
Homelessness Affects Urban and Rural Areas
A
- Reasons for homelessness are the same between urban and rural areas.
o Poverty. Most people don’t choose to be homeless - Estimations of people experiencing homelessness in urban areas are made based on people using services. Statistics are based on the people who take advantage of the services around them (shelter, food bank, soup kitchen, etc)
- Estimations of people experiencing homelessness in rural areas are usually low due to lack of rural service sites.
- People experiencing homelessness in rural areas are mostly white, female, married, employed, homeless for the first time, and experience homelessness for a shorter time.
11
Q
What are Rural Communities?
A
- Of or relating to the country, country people or life, or agriculture
o From Merriam Webster online dictionary - Small communities outside of cities or urban areas
12
Q
Social Determinants of Health (SDOH) that Influence Health Outcomes for People Living in Rural Communities:
Economic Stability
A
- Lower socioeconomic status/poverty due to:
o Lower paying jobs
o Instability in income, such as farming
Don’t always get the same income from farking (bad weather, low rivers, stuff that eats crops, not enough rain)
o Limited job opportunities when live in a small community, only so many opportunities available. If you don’t have a job and can’t move, it can be hard
o Incompletion of education may have dropped out of HS to help on the farm
Migrant farm workers with families kids may have to help on farm to make money for family
13
Q
Social Determinants of Health (SDOH) that Influence Health Outcomes for People Living in Rural Communities:
Education Access and Quality
A
- Under-resourced schools no AP classes and less resources
- People may drop out of high school for various reasons, work being one
- Rural residents who leave to attend college typically do not return to home town
- Those without a college education have a harder time accessing health care services and meeting their basic needs
- Early childhood education and development helps with long-term health and literacy
o If these services are not available, It will impact the quality of life for the families and children and their education
14
Q
Social Determinants of Health (SDOH) that Influence Health Outcomes for People Living in Rural Communities:
Health Care Access and Quality
A
- Scarcity of health care providers: NPs, MDs, RNs, PAs, Dentists
- Limited access to hospitals, provider offices, specialty health care services, and emergency care
o Hospitals are closing in small communities because do not have the funding to stay open - Limited access to primary health services such as gyms, trails
o Nearest gym may be more than 30 miles away - Lack of reliable transportation to health care services
o If nearest hospital is 60 miles away and they don’t have a car, how are they going to get there? What transportation is available to people?
15
Q
Social Determinants of Health (SDOH) that Influence Health Outcomes for People Living in Rural Communities:
Neighborhood and Built Environment
A
- Transportation- personal and public
- Housing quality
- Food access What is available?
- Environmental Quality
o Access to clean and safe water- plumbing, septic systems, lead pipes, wetlands and other natural filtering systems
o Land and contaminants
