Rural counties, especially those located adjacent to metropolitan areas have seen population growth. Challenges arrive along with these new Americans: How do two or three different cultures live together? How does a small clinic with limited resources accommodate different languages and different understandings about health and healing? The diabetic diet looks different from a Mexican diet where beans and rice are staples and different from the farmer who wants his meat and potatoes. Some workers arrive without family, leaving their wives and children back home for the season or several years. Problems such as alcohol abuse, sex trafficking, and violence often accompany this disconnected lifestyle.
(Excerpted and used with the permission of the author, published in The Country Doctor Revisited, KSU, 2010)
How do we meet the needs of patients that extend beyond the clinic. These are often called the social determinants of health. These play an important role in keeping people healthy and helping them achieve health. Health care professionals need a team to address these issues and that team includes public health, social workers, as wells a policy makers and community advocates. Pay attention in you community. Is your preceptor aware of the other factors affecting a patient’s situation? An alcohol problem? Housing problems? No money for food? Family problems?
Sometimes new Americans or immigrants have a more difficult situation because supports do not yet exist to help them and language barriers make it hard to communicate. If you community has immigrants, how are they welcomed into the health care setting? Interpreters? Signage? Specific patient education? Multi-lingual providers? Art on the clinic walls?
If you were in charge what would you do differently?