Building unity and establishing trust within communities is crucial to improving health care access and addressing inequities in rural America. That was a recurring theme at AHCJ’s 2023 Rural Health Workshop in Kansas City.
“When we go into these [rural] communities, they will not always tell us what we want to hear … but they will be very honest about their pain points,” said the event’s luncheon speaker, Lisse Regehr, president and CEO of Thrive Allen County, which won the prestigious Culture of Health Prize from the Robert Wood Johnson Foundation in 2017.
During the one-day workshop, which drew more than 60 people, Regehr said there are plenty of rural health care stories to tell if journalists are willing to do the work to make meaningful connections with people.
Making connections was crucial to Thrive Allen County’s success, even if face-to-face interactions with local residents were sometimes uncomfortable. “We learned really quickly that we had to get comfortable sitting in silence,” Regehr said. “ [People] don’t know if what they share with you will be heard and will be respected.”
Regehr also shared stories about how Thrive Allen County used creative solutions to improve health care both directly and indirectly in the county, which is less than two hours south and slightly west of Kansas City. For example, building a dog park for local residents encouraged socializing and exercise, and providing bikes for people without access to transportation had an impact. The dog park also drew some sorely needed new health care practitioners to town because for them, it was an important amenity. And in one situation, a bike made the difference for a man who needed to get to the ER but knew he couldn’t afford to pay for an ambulance.
The workshop also offered six informative sessions on topics like environmental health, maternal health, culturally appropriate mental and behavioral telehealth and harm reduction.
- In addition to providing an overview of rural demographics during the “Rural America: Demographics, innovation, and your next big story” panel, researcher Alana D. Knudson, Ph.D., recognized reporters for their efforts to cover health in rural areas.“Your work [as journalists] helps to lift our rural communities and flip a light on what is happening. And there are a lot of positive things happening out there as well as challenges,” she said.
But she cautioned journalists to be intentional about their framing of rural health stories, explaining that it can positively or negatively impact the people living in these areas. “This whole mantra of ‘older, sicker and poorer’ doesn’t serve rural… Because people don’t want to invest in areas that are older, sicker and poorer, and don’t have economic opportunity,” she said.
- In the “Finding a maternal health solution for rural America” session, registered dietitian Erin Coppenbarger defined maternity care deserts as counties without hospitals, obstetric care and obstetric providers. She also explained that most maternity care deserts have a higher percentage of women with chronic health conditions, which results in worse birth outcomes like preterm birth. A higher rate of these chronic conditions impacts communities that are already underserved, she added. Margo Snipe, a national health reporter for Capital B, discussed her “Dangerous Deliveries” series, which used March of Dimes data to track counties more likely to be maternity health care deserts. During her investigation, she found that since 1994 in Georgia, which is considered one of the most dangerous places to have a baby because of its high prevalence of care deserts, predominantly Black counties lost labor and delivery units at a higher rate than White counties.
- During the “Rural mental health: Reaching cultural competency” session,Total Farmer Health director and mental health lead for AgriSafe Tara Haskins, discussed the impact of COVID on the mental health of agricultural workers and how her organization helps inform and educate agricultural communities about how to protect themselves and their families. She also discussed the high rates of suicide among agricultural workers and how they might be uncomfortable calling helplines because of legal concerns.
- “Harm reduction is one of the best tools against preventing overdose,” said Allen Siegler, a public health reporter for Mountain State Spotlight, during the “How rural harm reduction fits into the fight against overdose” panel. He cited a dire outcome of the closing of a harm reduction program in West Virginia in 2018 after legislation was passed restricting syringe exchanges: a severe HIV outbreak in Charleston and Huntington counties.
The closing of that program was partly the result of bad journalism, said former state health official Cathy Slemp, explaining that a local media outlet took a fear-based approach to their reporting that added fuel to the fire.“The local media continued to use their stigmatizing and kind of ‘exciting’ headlines for years later,” she explained.
- During the “Health on the front line of environmental change” session, Lisa Patel, M.D., said “climate change will be the greatest determinant of health for a child born today.” She also urged reporters writing about climate change not to leave out the importance of mitigation or phasing out of fossil fuels. Antonio Tovar, the senior policy associate for the National Family Farm Coalition, discussed how the organization conducted community-based participatory research to find out how heat exposure was impacting farmers. After taking blood and urine samples, researchers found that several farmers started out with insufficient amounts of water and several of them experienced symptoms of heat stress. “The conditions of farmers aren’t going to change until you change the policies that are associated with labor conditions,” he said.
- During the final session, “How health care journalism can reach news deserts,” moderated by Arielle Zionts, a rural health reporter for KFF Health News, Kentucky Health News publisher and panelist Al Cross, shared an example of how his publication has helped raise the profile of health care in rural areas. Rural newspapers are unlikely to cover substance abuse beyond crime reports, which perpetuate the stigma that makes tackling addiction so challenging, he said. To help combat this problem, the Kentucky Health News hosted a workshop titled “Covering substance abuse and recovery” to remind people in the community “that there is hope and that the topic needs coverage,” Cross said.
To view photos and see presentations from this year’s workshop sessions, visit AHCJ’s 2023 Rural Health Workshop landing page.