Chapter 24: Rural & Migrant Health Nursing

Rural & Migrant Health Nursing provides a detailed framework for defining rurality, including frontier areas and core-based statistical areas, while contrasting these with urban environments. A significant portion of the discussion focuses on health disparities divided into contextual issues, which are derived from characteristics of the location such as geographic isolation and limited infrastructure, and compositional issues, which stem from the characteristics of the people themselves, including lower income levels and higher rates of uninsured individuals. The text addresses the unique occupational risks faced by agricultural and migrant workers, such as pesticide exposure, machinery accidents, and respiratory issues, highlighting the extreme vulnerability of migrant and seasonal farmworkers (MSFWs). Furthermore, it identifies major health concerns prevalent in rural aggregates, including elevated rates of chronic disease, obesity, and suicide, the latter of which is the second leading cause of death in these areas. The nursing perspective focuses on the concept of the "expert generalist" and the importance of upstream thinking to address environmental hazards and systemic barriers at their root. New models of care, such as telehealth, telemedicine, and the integration of patient-centered medical homes, are examined as essential tools for overcoming provider shortages and professional isolation. By maximizing informal care networks and collaborating with faith communities, nurses can bridge gaps in services for the elderly, children, and minority groups who face the greatest barriers to health equity in rural America.