community 8
Chapter 25 Rural, Urban, and Homeless Populations
Rural Populations
Definitions
Rural population characteristics
Perspectives and stereotypes
Issues, concepts, and populations
Health issues
Rural Populations
Based on geography and environment
Rural–urban continuum
Metropolitan statistical areas
Economists define rural counties by their economic base:
Farming dependent
Mining dependent
Manufacturing dependent
Government dependent
Services dependent
Nonspecialized counties
Rural Population
Characteristics
Non-metropolitan
Large proportion of elders
Health and social services deficient
Poverty
Ethnic and racial minority populations are growing
Perspectives
Stereotypes
Personal bias
Pre-existing ideas
Issues, Concepts, and Populations
Lifestyle
Unintentional injury
Intentional injury
Substance use and abuse
Sexual activity
Agriculture hazards
Isolation
Elders
Issues, Concepts, and Populations (cont.)
Culture
Migrant workers
Housing
Homeless
Confidentiality
Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)
Access to health care
Urban Populations
Urban population defined
At least 50,000 people in an incorporated or unincorporated area
Health and social problems
Lack of steady employment
Racial discrimination
Poor quality of life
High infant mortality rate
Ghetto counterculture
Urban sprawl
Programs for healthier urban people
Homeless Population
Scope of the problem
Definitions of homeless people
Historical perspective
1600s
Mid-1800s
20th century
Homeless Population (cont.)
Homelessness
Substance abuse
Racism
Violence
Limited education
Crime
Poverty
Homeless lifestyle—barrier to good health practices
Homeless Population (cont.)
Societal and governmental influences through 1970s
Federal Emergency Relief Administration
Societal and governmental influences through 1980s
Stewart McKinney Homeless Assistance Act of 1987
Societal and governmental influences through 1990s
Health Problems of Homeless People
Common health problems fall into three categories:
Those that contribute to a state of homelessness:
Chronic schizophrenia
Dementia
Personality disorders
AIDS
Alcoholism
Drug dependency
Degenerative diseases
Health Problems (cont.)
Those that are the consequence of homelessness:
Skin and blood vessel diseases
Respiratory disorders
Infections
Malnutrition
Parasitic infestations
Foot and lower extremity problems
Physical assault
Rape trauma
Periodontal disease
Tooth decay
Degenerative joint disease
Sexually transmitted infections
Cirrhosis
Hepatitis
Health Problems (cont.)
Those whose treatment is complicated by homelessness
Diabetes mellitus
Hypertension
Renal disease
Liver disease
Peripheral vascular disease
Schizophrenia
Infant mortality
HIV
Barriers to Health Care
Lack of access
Lack of systematic communication with healthcare professionals
Lack of transportation
Lack of social and family support
Psychological depression
Lack of motivation
Caring for Urban and Rural Populations
Principles
Be committed
Use leadership skills
Use available resources
Be an advocate
Foster communication and trust
Assess the problem
Plan and give care