Bringing local solutions to rural communities

Approximately 350,000 people call the Brazos Valley home. Of those, roughly 60 percent of the population lives in Brazos County, while the remaining 40 percent are spread throughout rural counties.  In contrast, roughly 90 percent of the health services and resources are located in Brazos County, and about 10 percent spread throughout the rural counties. This situation forces rural residents to travel to Bryan/College Station for many services they need.

The Center for Community Health Development (CCHD) at the Texas A&M Health Science Center School of Rural Public Health has been working with these rural communities over the past 12 years to help address these disparities. The Center has a mission to develop relationships with communities and populations across the state, and through those relationships, to discover and disseminate ways to improve health, particularly among the low-income and the underserved.

In its work with communities in the Brazos Valley, CCHD has partnered with local organizations to conduct regular health assessments in 2002, 2006, 2010, and 2013. The information provided through these assessments is used by organizations and communities for planning, grant-writing, and development of new programs and services. Each of the regional health assessments found that access to services is a persistent issue for rural residents, and that transportation is a significant barrier to accessing care. The most recent health assessment found that a third of all rural residents (32.9%) travel over 20 miles to obtain medical care, with residents in one county reporting an average distance to medical care of 42 miles.

In response to the access to care and transportation concerns, CCHD collaborated with service providers to assist in improving the health of local communities through the development of Health Resource Centers (HRCs) throughout the region. Currently, there are five rural HRCs in four of the Brazos Valley counties. The resource centers are located in donated facilities and serve as a place for providers to deliver services locally with low overhead costs. Of the services provided at the HRCs, transportation ranks among the highest in demand and utilization. The transportation program offers free rides to health-related destinations such as the doctor’s office, pharmacy, grocery store, senior centers, and to church functions.

Dolores Mitschke, a Grimes County resident who has utilized the transportation program, states that she “has no family nearby and would suffer greatly without the service.” Furthermore, she thinks that “the transportation service offered is not only helpful, but truly a necessary component of maintaining the health status of the people in the county,” and the numbers don’t lie. Records indicate that HRCs have given 40,789 rides to rural residents over the past seven years. It is obvious that these transportation services are a vital asset to the community.

In addition to transportation, the HRCs provide many services to local residents; each HRC is unique, ranging from an office suite in a local hospital’s professional building to being co-located with a federally qualified health center.  Equally unique, the services delivered at each center are based upon each community’s specific service needs and resources available. While all of the centers provide transportation services, three centers operate a senior home delivered meal program. Another hosts an audiologist once a week, while yet another center offers anger management and parenting classes.  Common services include information and referrals to other regional and local providers; case management; legal aid; utility assistance, and medication assistance to name a few.

Robert Shaw the Madison County Health Resource Executive Director, said “the resource centers offer a local entry point for community members to gain access to a wide variety of services that assist them in improving their overall health.”

Additionally, two HRCs across the region have now collaborated with CCHD affiliated faculty member, Tim Elliott, Ph.D., of the Texas A&M Counseling Psychology Program to deliver mental health services via telehealth to rural residents. Mental health was another significant issue identified through the health assessments, and this technology allows residents who previously did not have access to services to utilize local options without having to travel. In Leon County alone, the service has been used by more than 770 clients and has alleviated stress and decreased patients’ depressive symptoms. Due to the positive results of telehealth services at the HRCs and the demand for services elsewhere, Dr. Elliott has since created the Telehealth Counseling Clinic to expand availability of services to clients throughout the Brazos Valley.

“We are about helping communities build their skills in addressing complex health issues in ways that fit their community’s structure, resources, and culture. We know we are successful when communities continue to grow their services and programs on their own,” said Monica Wendel, Dr.P.H., M.A., CCHD Director. “These communities are resourceful and resilient—what they are doing serves as a model for rural communities across the country. It’s a privilege to be able to partner with them and be able to directly witness the impact on people’s lives.”

Learn more about the services offered by the Telehealth Counseling Clinic in this newscast from KRHD.