Ziska, 2016
Ziska, Lewis H.; “The role of climate change and increasing atmospheric carbon dioxide on weed management: Herbicide efficacy;” Agriculture, Ecosystems & Environment, 2016, 231, 304-309; DOI: 10.1016/j.agee.2016.07.014.
ABSTRACT: Rising concentrations of carbon dioxide [CO2] and a changing climate will almost certainly affect weed biology and demographics with consequences for crop productivity. The extent of such consequences could be minimal if weed management, particularly the widespread and effective use of herbicides, minimizes any future risk; but, such an outcome assumes that [CO2] or climate change will not affect herbicide efficacy per se. Is this a fair assumption? While additional data are greatly desired, there is sufficient information currently available to begin an initial assessment of both the physical and biological constraints likely to occur before, during and following herbicide application. The assessment provided here, while preliminary, reviews a number of physical and biological interactions that are likely, overall, to significantly reduce herbicide efficacy. These interactions can range from climatic extremes that influence spray coverage and field access to direct effects of [CO2] or temperature on plant biochemistry and morphology. Identification of these mechanisms will be essential to both understand and strengthen weed management strategies associated with rising levels of [CO2] in the context of an uncertain and rapidly changing climate.
Ziska, 2016
Ziska, Lewis H.; “The role of climate change and increasing atmospheric carbon dioxide on weed management: Herbicide efficacy;” Agriculture, Ecosystems & Environment, 2016, 231, 304-309; DOI: 10.1016/j.agee.2016.07.014.
ABSTRACT: Rising concentrations of carbon dioxide [CO2] and a changing climate will almost certainly affect weed biology and demographics with consequences for crop productivity. The extent of such consequences could be minimal if weed management, particularly the widespread and effective use of herbicides, minimizes any future risk; but, such an outcome assumes that [CO2] or climate change will not affect herbicide efficacy per se. Is this a fair assumption? While additional data are greatly desired, there is sufficient information currently available to begin an initial assessment of both the physical and biological constraints likely to occur before, during and following herbicide application. The assessment provided here, while preliminary, reviews a number of physical and biological interactions that are likely, overall, to significantly reduce herbicide efficacy. These interactions can range from climatic extremes that influence spray coverage and field access to direct effects of [CO2] or temperature on plant biochemistry and morphology. Identification of these mechanisms will be essential to both understand and strengthen weed management strategies associated with rising levels of [CO2] in the context of an uncertain and rapidly changing climate.
American College of Obstetricians and Gynecologists, 2014
The American College of Obstetricians and Gynecologists; “Health Disparities in Rural Women;” Committee Opinion, 2014, 586.
ABSTRACT:
Rural women experience poorer health outcomes and have less access to health care than urban women. Many rural areas have limited numbers of health care providers, especially women’s health providers. Rural America is heterogeneous where problems vary depending on the region and state. Health care professionals should be aware of this issue and advocate for reducing health disparities in rural women. FULL TEXT
Diepietro Mager, 2020
DiPietro Mager, Natalie Ann. (2020). Preconception and Interconception Health and Routine Health Service Use Among Women in a Rural Midwestern County (Doctor of Philosophy), Indiana University.
ABSTRACT:
Advancement of preconception and interconception health is a key element to improve women’s health as well as pregnancy outcomes. Little is known about the preconception and interconception health status of rural Midwestern populations in the United States. The primary objective of this study was to determine the preconception and interconception health status as well as behaviors of reproductive age women living in a rural Midwestern area. Secondary objectives were to quantify process measures of health care access and barriers to care, as well as determine disparities in preconception and interconception health status among women in this rural area as compared to statewide estimates. As existing national or state secondary data sources often have limitations in data derived from areas with low population densities or insufficient sample sizes to generate reliable estimates, a cross-sectional study was performed using a 34item survey. Data were collected from February to May 2019 from 315 non-pregnant women ages 18-45 years in a rural county in northwestern Ohio. Nearly all women surveyed had at least one risk factor associated with poor pregnancy outcomes, many of which were modifiable. Nearly half of all respondents reported at least one barrier to receipt of health care services. Women in this rural county fared worse for several preconception and interconception health measures when compared to statewide estimates derived from Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey data. These findings illustrate the need for continued development of interventions to improve preconception and interconception health for rural women as well as improved methods to capture and analyze data on important subpopulations at risk.
Bloom et al., 2012
Bloom, T. L., Bullock, L. F., & Parsons, L.; “Rural pregnant women’s stressors and priorities for stress reduction;” Issues in Mental Health Nursing, 2012, 33(12), 813-819; DOI: 10.3109/01612840.2012.712087.
ABSTRACT:
Rural residence and maternal stress are risk factors for adverse maternal-child health outcomes across the globe, but rural women have been largely overlooked in maternal stress research. We recruited low-income, rural pregnant women for qualitative interviews to explore their stress exposures during pregnancy, reactions to stress, and priorities for stress reduction. We also used quantitative measures (Perceived Stress Scale, Center for Epidemiologic Studies of Depression Scale-Revised, Posttraumatic Stress Disorder Checklist-Civilian, Lifetime Exposure to Violence Scale) to describe stress exposures and reactions. We interviewed 24 pregnant rural women from a Midwestern US state, who were primarily young, white, partnered, and unemployed. Women’s predominant stressor was financial stress, compounded by a lack of employment, transportation, and affordable housing options; extended family interdependence; small-town gossip; isolation/loneliness; and boredom. Quantitative measures revealed high levels of global perceived stress, violence exposure, and symptoms of depression and posttraumatic stress disorder among the sample. Women most commonly reported that employment and interventions to increase their employability would most effectively decrease their stress, but faced numerous barriers to education or job training. Tested maternal stress interventions to date include nurse-case management, teaching women stress management techniques, and mind-body interventions. Pregnant women’s own priorities for stress-reduction intervention may differ, depending on the population under study. Our findings suggest that rural clinicians should address maternal stress, violence exposure, and mental health symptoms in prenatal care visits and that clinicians and researchers should include the voices of rural women in the conceptualization, design, implementation, and evaluation of maternal stress-reduction interventions.
Blewett et al., 2004
Blewett, Lynn A., Casey, Michelle M., & Call, Kathleen T.; “Improving Access to Primary Care for a Growing Latino Population: The Role of Safety Net Providers in the Rural Midwest;” Health Services Safety Net, 2004, Summer 2004.
ABSTRACT:
Context: Many rural Midwestern communities are experiencing rapid growth in Latino populations with low rates of health insurance coverage, limited financial resources, language and cultural differences, and special health care needs. Purpose: We report on 2-day site visits conducted in 2001 and 2002 in 3 communities (Marshalltown, Iowa; Great Bend, Kansas; and Norfolk, Nebraska) to document successful strategies to meet Latino health care needs. Methods: We interviewed key informants to identify successful community strategies for dealing with health care access challenges facing the growing Latino population in the Midwest. Findings: Interventions have been developed to meet new demands including (1) use of free clinics, (2) school health programs, (3) outreach by public health, social services and religious organizations, and (4) health care providers’ efforts to communicate with patients in Spanish. Strain on safety net services for Latinos is due in part to a complicated and unstable mix of public and private funds, a large but overtaxed volunteer provider base, the dependence on a limited number of community leaders, and limited time for coordination and documentation of activities. Conclusions: We suggest the development of a Rural Safety Net Support System to provide targeted funding to rural areas with growing immigrant populations. Federal community health center support could be redirected to new and existing safety net providers to support the development of a safety net monitoring system.
Casey et al., 2004
Casey, Michelle M., Blewett, Lynn A., & Call, Kathleen T.; “Providing Health Care to Latino Immigrants: Community-Based Efforts in the Rural Midwest;” American Journal of Public Health, 2004, 94(10), 1709-1711; DOI: 10.2105/AJPH.94.10.1709.
ABSTRACT:
We examined case studies of 3 rural Midwestern communities to assess local health care systems response to rapidly growing Latino populations. Currently, clinics provide free or low-cost care, and schools, public health, social services, and religious organizations connect Latinos to the health care system. However, many unmet health care needs result from lack of health insurance, limited income, and linguistic and cultural barriers. Targeted safety net funding would help meet Latino health care needs in rural communities with limited resources. FULL TEXT
Askelson et al., 2020
Askelson, N., Ryan, G., Pieper, F., Bash-Brooks, W., Rasmusson, A., Greene, M., & Buckert, A.; “Perspectives on Implementation: Challenges and Successes of a Program Designed to Support Expectant and Parenting Community College Students in Rural, Midwestern State;” Maternal Child Health Journal, 2020, 24(Suppl 2), 152-162; DOI: 10.1007/s10995-020-02879-6.
ABSTRACT:
OBJECTIVES: Expectant and parenting students (EPS) at community colleges are an underserved and often under-resourced group. In a rural, Midwestern state, the department of public health was awarded the Pregnancy Assistance Fund (PAF) grant to assist this population. This paper outlines the results of the implementation evaluation and offers suggestions for programs and evaluators working with this population in the community college setting.
METHODS: We conducted a multicomponent evaluation utilizing quantitative and qualitative methods. Evaluation activities included tracking activities/services, surveys and interviews with participants, and interviews with community college staff implementing grant activities. The research team calculated frequencies for quantitative data and coded qualitative data for themes.
RESULTS: Data from the community colleges and students’ self-reports revealed that EPS most commonly received concrete support from the program, often in the form of stipends or gift cards. Students reported that concrete support was beneficial and helped to relieve financial stress during the semester. Students’ major barriers to participation were lack of knowledge about the program and busy schedules that prevented them from accessing PAF services. Staff reported that difficulty identifying EPS and the short one-year project period were major implementation challenges.
CONCLUSIONS FOR PRACTICE: We recommend that community colleges work to identify EPS, use fellow EPS to recruit program participants, and implement programming that works with the students’ schedules.
Mwangi and Constance-Higgins, 2017
Mwangi, E. Wairimu, & Constance-Huggins, Monique; “Intersectionality and Black Women’s Health: Making Room for Rurality;” Journal of Progressive Human Services, 2017, 30(1), 11-24; DOI: 10.1080/10428232.2017.1399037.
ABSTRACT:
Black women have poorer health compared to their White counterparts in a range of health outcomes, including breast cancer, diabetes, HIV/AIDS, and heart disease. The health disparities literature has largely treated women as a monolithic group, assuming that health practices and treatments are equally applicable and effective for all women. This approach, which places too much emphasis on gender, risks masking the unique experiences of various women based on other social categories. This article argues that in order to advance Black women’s health, an intersectionality approach should be incorporated into health research and practice. This approach, however, should go beyond the usual intersection of race and gender to include rurality. The article builds this argument on the fact that Black women living in rural areas have unique experiences that intersect with their gender, race, and class status. Benefits for embracing the intersectionality approach are discussed
Luke et al., 2021
Luke, A. A., Huang, K., Lindley, K. J., Carter, E. B., & Joynt Maddox, K. E.; “Severe Maternal Morbidity, Race, and Rurality: Trends Using the National Inpatient Sample, 2012-2017;” J Womens Health (Larchmt), 2021, 30(6), 837-847; DOI: 10.1089/jwh.2020.8606.
ABSTRACT:
BACKGROUND: Severe maternal morbidity is related to maternal mortality and an important measure of maternal health outcomes. Our objective was to evaluate differences in rates of severe maternal morbidity and mortality (SMM&M) by rurality and race, and examine these trends over time.
MATERIALS AND METHODS: It involves the retrospective cohort study of delivery hospitalizations from January 1, 2012 to December 31, 2017 from the National Inpatient Sample. We identified delivery hospitalizations using International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis and procedure codes and diagnosis-related groups. We used hierarchical regression models controlling for insurance status, income, age, comorbidities, and hospital characteristics to model odds of SMM&M.
RESULTS: The eligible cohort contained 4,494,089 delivery hospitalizations. Compared with women from small cities, women in the most urban and most rural areas had higher odds of SMM&M (urban adjusted odds ratio [aOR] 1.09, 95% confidence interval [1.04-1.14]; noncore rural aOR 1.24 [1.18-1.31]). Among White women, the highest odds of SMM&M were in noncore rural counties (aOR 1.20 [1.12-1.27]), while among Black women the highest odds were in urban (aOR 1.21 [1.11-1.31]) and micropolitan areas (aOR 1.36 [1.19-1.57]). Findings were similar for Hispanic, Native American, and other race women. Rates of SMM&M increased from 2012 to 2017, especially among urban patients.
CONCLUSIONS: Women in the most urban and most rural counties experienced higher odds of SMM&M, and these relationships differed by race. These findings suggest particular areas for clinical leaders and policymakers to target to reduce geographic and racial disparities in maternal outcomes.