National Rural Health Association --
Reflections of a Student

by… Treah Haggerty, MD Candidate

Treah Haggerty is a member of the class of 2007 in the West Virginia University School of Medicine. Originally from Daniels, WV in Raleigh County, she is a 1999 graduate of Shay Spring High School, and a 2003 graduate in Aerospace Engineering from West Virginia University.

As a recipient of a scholarship to the National Rural Health Association Conference, I was given the opportunity to hear many presentations about trends in rural health, actions being taken in rural communities, and the future in rural medicine. Many health care professionals and public administration professionals came from across the nation to New Orleans to collaborate on rural health initiatives in their own areas and the problems they foresee for the future of rural health. I learned details of successful programs, solutions to problems common to rural health programs and breadth of ideas for caring for underserved communities.

To start, I attended the Annual Rural Minority and Multicultural Health Conference. The keynote speaker, Dr. Mary Harper, discussed the disparities found in healthcare for racial, ethnic and other vulnerable groups across the United States. She focused on the problems overcoming the mistrust engendered by the Tuskegee Syphilis Study in the African American community and lingering effects of that study on healthcare in minority groups today. She had many ideas for overcoming the many problems that limit rural health care initiatives. She expressed a belief that the healthcare field must be aware of the disease process along with the pharmacokinetics and pharmicodynamics within different racial and minority groups.
A copy of her paper may be found at http://www.nrharural.org/conf/pdf/DrHarper.doc.

Following this session, I attended a roundtable discussion covering program actions to overcome the AIDS crisis seen here in the United States in rural areas. The topic was based on the ABC (abstinence, be faithful, condom usage) method promoted for HIV prevention today. It was stated that while one component (A, B or C) can be promoted more heavily, no other method should be condemned. Members of the audience discussed their feelings about the three components and it was clear that many people had strong feelings. One attendee discussed his work with patients who were substance abusers and how the best promotion for his patients was often condom usage due to hypersexual states while under the influence of the substances while others worked with different demographics that would do better with abstinence. The differing perspectives made a very lively discussion.

The next day was the start of the Rural Health Conference where the key note speaker, Dr. Neil Shulman, woke the crowd with a comedic, yet serious, presentation about rural health and keeping life light. Dr. Shulman is best known for his novel-turned-movie, "Doc Hollywood." He devotes his life to promoting the importance of laughter and educating children about doctor visits. Dr. Shulman entertained the crowd with his simple facts, evoking much laughter, such as “Life is just a dash between 2 numbers on a tombstone” along with other simple life jokes that demonstrated the value of laughter. Dr. Shulman discussed his upcoming and ongoing projects.

Red Light Warning Signals (http://www.redlightwarningsignals.com/)

Whose Nose (http://www.whonose.com/)

Doc Hollywood (www.dochollywood.com/)

Another conference lecture I attended highlighted the successes seen in Randolph County, Indiana in their attempt to reduce emergency room visits for health concerns which could best be seen in a primary care setting. To achieve this, the Community Access Program (CAP) went through 5 steps. They first identified the people who were vulnerable. From there they assessed family needs and health risks, and available health care programs. With this knowledge, they were able to refer families to existing available resources and primary care centers. The CAP participants also served as healthcare advocates for vulnerable persons so they could learn of and utilize the resources already available. Due to CAP efforts, Randolph County saw about a 16% drop in ER visits for primary care health issues. Along with this, they saw a drop in the number of underinsured and enhanced chronic disease management. Patients were referred to:

This comprehensive program was a huge success, with implications for other communities that may also need services coordinated for more efficient delivery to populations who may not necessarily know of the many programs to which they have access.

One day of the conference I was given the opportunity to work with a television producer, along with other students from all over the country, to create a media campaign for the National Rural Health Association. The producer, Antonio Lopez, often works with inner city students, creating media presentations to create positive change in society. He guided the group of six students to plan a video, write the script, and record the film and he demonstrated how he will put the film together. We chose to do a simple message highlighting the mission statement of NRHA, directed to rural community members searching for advocate help for their health care needs.

The seven key features of the mission statement for our film:

1. All Americans are entitled to an equitable level of health and well-being established through health care services regardless of geographic locale, gender, ethnic or racial background, or economic ability or status.
2. Access to primary and preventive health care services should be available locally to rural residents to achieve the goal of preventing illness whenever possible.
3. An overarching goal of the Association is to foster service partnerships among health care providers and facilities rather than focusing on the disciplines.
4. The Association recognizes the value that each member brings to the improvement of rural health care services and values the multicultural diversity of its membership. Additionally, the Association realizes the broader scope of solutions and opportunities that may be achieved through the grassroots efforts of this diverse membership.
5. The Association recognizes that collegiality and partnerships with and among other associations may serve to enhance or increase rural health accomplishments.
6. The Association believes local residents should be involved in determining the health care needed and provided in their communities.
7. The Association values and strives to achieve its role in helping members provide the best possible health care services by offering continuing education and information on rural health related issues, policy and research. (www.nrharural.org)

Overall the conference made me aware of the variety and scope of programming in rural areas aimed at improving healthcare, access to healthcare, and education about healthcare. Some of the presentations were grim, many were fun and all were inspiring. I was astounded at how many programs are making a real difference to rural healthcare customers by improving care programs or improving access to existing care programming. I found people working in areas as diverse as film production, public administration and direct care, all to improve the availabilty to health care for underserved people. It was a fun, inspiring and educational experience.