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Arnold School of Public Health

HSPM’s Janice Probst examines factors affecting the health of children in rural America

November 18, 2016 | Erin Bluvas, 

In 2011, the National Institute of Child Health and Human Development (NICHD) convened experts to provide insight into issues affecting rural children at the “Health Outcomes among Children and Families Living in Rural Communities” conference (see video). Five years later, the work continues.

After the conference, NICHD encouraged participants to use their exchanges as a springboard for further collaboration with one another. Professor of Health Services Policy and Management Janice Probst, who directs the South Carolina Rural Health Research Center, teamed up with Judith Barker, Alexandra Enders, and Paula Gardiner to examine how children’s health is influenced by the context in which they live, particularly in rural America.

The authors looked at factors, such as economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children, with the goal of highlighting features of the rural environment that may affect health. They published their observations on the health status of children in rural America in The Journal of Rural Health.

“Rural children are generally as healthy as their urban peers, as reported by their parents,” says Probst. “But they are more likely to be overweight than urban children, and research suggests that they may be more likely to engage in risky behaviors, such as underage drinking. Rural adolescents are also more likely to give birth while in their teens than urban girls.”

The researchers note that the nearly 12 million children who live in rural America experience higher rates of poverty than their urban counterparts and have consistently lower access to care. “They are less likely to have had a preventive, such as a well-baby checkup, medical or dental visit in the past year,” says Probst. Closing this gap requires innovative teamwork.

“When you’ve got to make do with less, you’ve got to be creative and collaborative,” says Probst. “Rural communities need to think of solutions for provider shortages that go beyond simply trying to recruit more physicians and nurses, such as telemedicine. Communities also need to recruit the entire spectrum of organizations that affect children to the cause of children’s health.”

Libraries, parks, schools, churches and other groups, for example, can influence health factors such as obesity and risk behavior—according to the authors. For teens, mobile apps may have value as well. These suggestions, of course, come with the call for additional research to identify the most effective solutions.

Moving forward, Probst is currently analyzing a decade of nationwide data related children’s health. “We wanted to examine trends in rural children’s health over time to ascertain if there are specific health conditions or behaviors in which rural children are falling behind,” she says. “At the same time, we need additional surveillance to find ‘bright spots,’ communities in which children’s health and welfare is addressed and supported broadly.” 

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