Person and Place: The Compounding Effects of Race/Ethnicity and Rurality on Health

Probst, Janice C.; Moore, Charity G.; Glover, Saundra H.; Samuels, Michael E.

doi:10.2105/ajph.94.10.1695

Cited by 289 publications

(277 citation statements)

References 75 publications

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“…This limitation is important because although many rural counties are predominantly non-Hispanic white, high numbers of African American, Hispanic, and Native American populations are geographically concentrated in several rural regions, often where health care disparities are the most acute. [36][37][38] Finally, the study results may be influenced by our interpretation as researchers; we sought to minimize this bias by engaging in a continuous process of reflexivity.To read or post commentaries in response to this article, see it online at http://www.annfammed.org/content/14/3/244. …”

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confidence: 99%

Rural Women Family Physicians: Strategies for Successful Work-Life Balance

Phillips

Hustedde

Björkman

et al. 2016

The Annals of Family Medicine

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PURPOSE Women family physicians experience challenges in maintaining worklife balance while practicing in rural communities. We sought to better understand the personal and professional strategies that enable women in rural family medicine to balance work and personal demands and achieve long-term career satisfaction.METHODS Women family physicians practicing in rural communities in the United States were interviewed using a semistructured format. Interviews were recorded, professionally transcribed, and analyzed using an immersion and crystallization approach, followed by detailed coding of emergent themes. RESULTSThe 25 participants described a set of strategies that facilitated successful work-life balance. First, they used reduced or flexible work hours to help achieve balance with personal roles. Second, many had supportive relationships with spouses and partners, parents, or other members of the community, which facilitated their ability to be readily available to their patients. Third, participants maintained clear boundaries around their work lives, which helped them to have adequate time for parenting, recreation, and rest.CONCLUSIONS Women family physicians can build successful careers in rural communities, but supportive employers, relationships, and patient approaches provide a foundation for this success. Educators, employers, communities, and policymakers can adapt their practices to help women family physicians thrive in rural communities. 2016;14:244-251. doi: 10.1370/afm.1931. Ann Fam Med INTRODUCTIONT he United States faces a chronic, severe shortage of rural physicians, which has a negative impact on population health.1-4 Rural America is economically, socially, and environmentally diverse, yet residents of rural communities share common difficulties accessing health care, including longer distances to care, and a disproportionate shortage of women and minority physicians.5-8 A lack of women rural physicians especially limits access to care for women patients, who often prefer women clinicians and appear to complete more screening tests when seen by women. 9 Rural female physicians are also more likely to attend births than male peers, 10,11 an important practice characteristic as many rural areas have a shortage of obstetrics professionals. 12,13 Promoting the success of women family physicians in rural communities is therefore important for community health.Acknowledging that women are an essential component of the rural physician workforce, 6 several studies have explored what factors attract women to rural practice and enable their success. Many rural physicians have had rural life experience.14,15 Previous studies have described common joys associated with rural practice, including multidimensional patient relationships, [16][17][18] the variety and professional challenges associated with a broad scope of practice, 10,18 the opportunity to serve one's community, [17][18][19][20] clinical autonomy, 17 and the attractions of small town life. 17,18,20 Women physicians also report no...

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Rural Women Family Physicians: Strategies for Successful Work-Life Balance

Phillips

Hustedde

Björkman

et al. 2016

The Annals of Family Medicine

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“…The third measure, the rate of serious complications due to perforation, is historically predicted to be between 1 per 500 and 1 per 1000. 34 Fortunately, though, these primary care physicians have experienced only one fourth of this rate. Admittedly, the primary care physicians screen their healthy asymptomatic patients and continue to refer those patients who pose higher risks or require diagnostic evaluation of symptoms.…”

Section: Primary Care Physician Trainingmentioning

confidence: 99%

Racial disparities in colon cancer

Lloyd

Harvey

Hébert

et al. 2007

Cancer

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Colon cancer is a condition whose far‐reaching effects have been well documented nationally and within the state of South Carolina. Fortunately, the disease is amenable to both primary and secondary prevention through screening colonoscopy. Despite the conceptual simplicity of recommending colonoscopy, barriers exist to universal (or even widespread) screening. Currently the infrastructure necessary to achieve screening goals set by the American Cancer Society (ACS), the American College of Gastroenterology (ACG), and the South Carolina Department of Health and Environmental Control (DHEC) has not been established. At current rates of training gastroenterologists, the medical community will not be able to come close to achieving widespread screening. Given the discrepancy between the public health benefit of achieving the goals and the deaths that have occurred because of the resource shortfall, we propose alternative measures to screen the at‐risk population for consideration. This need is most acute in the black community, in which where screening rates tend to be lower and polyps have been found to progress more quickly than among white populations. In South Carolina, one model has used primary care physicians as the labor force to provide routine screening colonoscopy for their own patients. This model makes screening much more accessible to minority patients, as the wait is shorter and the cost typically lower. In combination with a faith‐based partnership with minority religious organizations, this model has begun to make needed inroads toward addressing the disparities associated with colon cancer. Cancer 2007. © 2006 American Cancer Society.

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“…There is strong evidence that asthma has a higher prevalence in rural populations [1,3,11]. Furthermore, Probst, et al (2004) reported that health disparities among rural minority populations were more severe than among urban minorities for a number of health-related conditions [12].…”

Section: Introductionmentioning

confidence: 99%