An ecological perspective on rural, low-income mothers' health

Promoting Environmental Justice and Sustainability in Social Work Practice in Rural Community: A Systematic Review

Social work’s response to global climate change has dramatically increased over the last several years. Similarly, growing attention has been paid to rural social work; less clear, however, is how social work, responsive to global climate change, is developed, deployed, and understood in rural contexts; this systematic review elaborates on current social work contributions (research, practice, and policymaking), promoting environmental justice and sustainability in rural communities. Utilizing the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, this article thematically analyzed and synthesized 174 journal articles on social work-specific interventions and environmental justice. The results illustrate insights into the experiences, practices, or objectives of rural social workers vis-à-vis climate change. Significant themes from the literature demonstrated that gender, age, and race limited access to social work services and climate-related disaster response support in rural settings; this article argues that rural community-driven social work practices focused on environmental justice and sustainability should be encouraged and that policy advocacy attentive to climate change and its impact on vulnerable and marginalized groups should be pursued. Current and prospective social work scholars, practitioners, policymakers, and other stakeholders should collaborate with local rural communities to address their unique needs related to climate change. In turn, grassroots strategies should be co-developed to promote climate change adaptation and disaster risk reduction, ultimately achieving the goal of building resilient, healthy, and sustainable rural communities.

Understanding Social Determinants of Cardiometabolic Disease Risk in Rural Women

Women living in rural America experience significant disparities in cardiometabolic diseases warranting research to aid in understanding the contextual factors that underlie the rural and urban disparity and in planning effective primary prevention interventions. While research has established a general understanding of cardiometabolic risks individually, the combination or bundling of these risk behaviors is not clearly understood. The purpose of this study is to explore the association of social determinants of health on obesity and adiposity related cardiometabolic disease risk among rural women. Data were from the multi-state Rural Families Speak about Health Study. A total of 399 women were included in the analyses. Data were collected using a self-administered questionnaire on women's demographics, economic stability, education, and health and healthcare. Food insecurity, education, healthcare access and comprehension health literacy were associated with higher obesity and adiposity-related cardiometabolic risk. Health behaviors, tobacco use and physical activity were not associated with higher cardiometabolic risk in this sample of rural women. This is one of the first studies to focus on multiple social determinants of health and cardiometabolic risk in rural American women. Understanding combinations of risk behaviors can assist health care providers and community health professionals in tailoring multiple health behavior change interventions to prevent cardiometabolic disease among rural women. The findings support a focus on community and societal level factors may be more beneficial for improving the cardiometabolic health of rural women.

Latino Solo Grandparents Raising Grandchildren: Health Risks and Behaviors

INTRODUCTION

The purpose of this descriptive report is to provide the first representative information on the sociodemographic profile and the prevalence of mental and physical health conditions of two "at-risk" groups of Latino caregivers: solo grandparent caregivers and single parents.

METHODS

The 2012 Behavior Risk Factor Surveillance System was used to compare five dimensions of health on a sample of Latino solo grandparents and Latino single parents, raising their grandchildren/children alone. Bivariate and logistic regression comparative analyses were conducted on study measures.

RESULTS

Latino solo grandparents have a high prevalence of chronic health conditions, including arthritis (51%), depression (40%), diabetes (34%), and asthma (34%). Latino single parents have lower but troubling health risks, including depression (22%), diabetes (14%), and asthma (14%). Differences between the two groups were largely due to the grandparents older age.

DISCUSSION

Latino solo grandparents have a high prevalence of several chronic medical conditions. The prevalence of disorders is much lower for Latino single parents, although they too have disturbing health risks.

CONCLUSION

Latino solo grandparents perform their parenting role under intense physical and emotional strain. Health professionals can be instrumental in facilitating interventions that affect the well-being of this expanding family group.

Understanding Multiple Behavioral Risk Factors for Cancer in Rural Women

OBJECTIVES

To examine the demographic and health-related factors associated with risk behaviors that have been linked to cancer including smoking, high BMI, and low physical activity.

DESIGN AND SAMPLE

A secondary analysis was conducted using data from Rural Families Speak about Health, a multistate, epidemiologic study of rural American women and their families (N = 444).

MEASURES

Validated measures for various demographic and health-related items including tobacco use, BMI, physical activity, and depression were used.

RESULTS

Of the total sample with complete data (n = 399), the mean age was 32 years and the majority were White (64%), married (67%), had a high school education or higher (73%), and had an annual household income of less than $40,000 (90%). Regarding cancer risk behaviors, 36% of the sample were smokers, 39% reported low levels of physical activity, and 45% had a calculated BMI over 30. Thirty-five percent of participants reported engaging in two or more risk behaviors. There were significant differences in income, perceived health status, and depression depending on the number of risk behaviors reported.

CONCLUSIONS

Understanding combinations of risk behaviors can assist nurses and other health professionals in tailoring multiple health behavior change interventions to prevent cancer among rural women.

Public and personal depression stigma in a rural American female sample

We examined public and personal stigma among a community sample of 1,000 women living in primarily rural counties of Western Kentucky. Data on demographics, depression, stigma, health information sources, and availability of health services were collected via a random digit dial survey. The prevalence of depression was 15.7%. The majority of respondents (82.2%) reported congruent levels of stigma with 11.6% reporting high public and high personal stigma. However, 17.8% of respondents reported incongruent public and personal stigma. The 7.5% of women with low public and high personal stigma were older and less educated, preferred anonymous sources of health information, and reported better availability of health services. The 10.3% of women with high public and low personal stigma were younger and more educated, preferred interpersonal sources of health information, and reported poorer availability of health services. In multivariate analyses, depression and lower education were associated with any incongruent stigma, while rural residence and White race/ethnicity was associated with high personal and public stigma. Psychiatric nurses should develop community-based and targeted, point-of-care interventions to reduce public and personal stigma among rural women.