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Interactions of Individual, Family, Community, and Policy Contexts on the Mental and Physical Health of Diverse Rural Low-income Families
Community and Leadership Development
The purpose of this multi-state project is to examine the effects of interactions among individual, family, community, and policy contexts on the physical and mental health outcomes for rural low-income families. It extends the previous research conducted within the multi-state projects NC223 and NC1011.
Good mental and physical health are important for quality of life. However, research shows rural residents experience health disparities in the incidence, prevalence, morbidity, and mortality rates for disease. Understanding the factors or combination of factors that contribute to these disparities can help to improve the quality of life among low-income rural families.
Investigators in this project will collect quantitative and qualitative data from approximately 600 families living in ten states. Data will be collected on health outcomes, family and individual level characteristics, community factors, and policies affecting low-income families. Quantitative data will be collected in years 2 and 4, and in-depth qualitative data will be collected in year 3. Data will be analyzed to assess the independent and combined contributions of individual, family, community, and policy contexts on health outcomes for the participating families.
As a result of this project, we expect to the body of knowledge regarding the well-being of rural communities and diverse rural low-income families. A better understanding of rural family health can lead to better quality of life and therefore sustainable rural communities. Families who are not healthy are not able to contribute to their communities, socially or economically. The study will provide data for customizing programs and public policy to meet the needs of rural America. It also will expand the capacity of the land-grant system to educate and train graduate student researchers; enrich the curricula of courses in sociology, economics, family studies, nutrition and health; inform the programming that Cooperative Extension offers to families and communities across each state; and extend expertise of the system to citizens in support of the prosperity of rural America.
2009 Project Description
Analyses continued on data collected from former NC223/1011 projects while survey protocols were being developed for a new wave of data collection in several low-income Appalachian counties in 2010. One major output was the development and dissemination of the Blue to You (www.bluetoyou.org)county extension program designed to educate rural residents about depression.
Other research findings related to health, food insecurity, and employment challenges faced by low-income rural families were presented at national professional meetings to researchers and practitioners as follows:
Kropczynski, J. & Dyk, P. (2009, February) Balancing Work and Health Challenges in Low-Income Rural Families. (oral, symposium)Southern Rural Sociological Association. Atlanta, GA. Findings from a subsample of Appalachian families children's health issues impacted mothers' ability to be consistently employed, where partners' employment was less impacted by child health issues.
Huddleston-Casas, C. A., Simmons, L. A. & Bush, H. M. (2009, April). Maternal Depression, Food Insecurity and Child Health Problems in Rural Low-income Families (oral, symposium). Society for Research on Child Development. Denver, CO. Examined the relationships between maternal depression, household food insecurity, and child health problems finding that the proportion of children living in households reporting food insecurity with hunger was greater for children with health problems than for children without health problems.
Kropczynski, J. & Dyk, P. (2009, August) Balancing Work, School and Family Health: Examining the Impact of Health Challenges in Low-Income Rural Families (oral, symposium. Rural Sociological Society. Madison, WI Abstract: Examined how health barriers within the family affect the ability to attend work and school. Children's injuries or illness had an effect on mothers' consistent employment, while partner's health challenges were most strongly correlated with their own health barriers.
Findings from our work in Kentucky show that poverty and health status are consistently linked for rural families, and the recursive nature of the relationships between poverty and poverty-related household characteristics (e.g., food insecurity) and family health status may contribute to a cycle of poverty. Depression is a persistent health problem that affects poverty status and child health. Women with depression have been shown to be less likely to access a physician when necessary. Women with depression also are more likely to experience food insecurity. In turn, food insecurity has been shown to be associated with child health problems.
We also have seen that child illnesses and injuries have been associated with inconsistent employment, which can contribute to increased poverty. Illness, injury, and chronic health problems also are associated with a decreased likelihood prescription compliance and increased likelihood of not seeking a physician when needed. Conversely, having health insurance has been found to increase the likelihood that rural women access physicians when needed.
These findings have important implications for health policy, and specifically, the health care debate currently underway at the Federal level. The findings related to depression have been used as the basis for the development of a county extension program, Blue to You (www.bluetoyou.org), to educate rural residents about depression.
Huddleston-Casas, C. A., Charnigo, R., & Simmons, L. A. (2009). Household food insecurity and depression over time among rural, low-income women. Public Health Nutrition, 12(8), 1133-1140