Environmental Barriers to Social Services in Rural Communities

Danielle Mitchell
Paulichia Woody
Dr. Ebony L. Hall*
Tarleton State University

Keywords: rural, community, social services, social work practice

Abstract

Historically, rural communities have encountered environmental barriers regarding the accessibility and efficiency of social services, having to travel longer distance to access health care placing a heavy reliance on practitioners. This study examines the environmental barriers that define rural communities, the inconsistency in supply and demand for social services such as food, shelter, and security, differences between urban and rural communities, and implications for social work practice. Researchers used a mixed methodological approach in order to examine the adequacy of social services in rural communities with a sample size of 361 participants who lived and/or worked within a rural community. Research confirms that social services in the rural community are limited and political advocacy for resources is vital towards improvements within agencies and organizations serving rural areas.

Introduction

As the social work profession continues to fulfill its mission of enhancing human well-being of individuals and society, it is fundamental to explore environmental obstacles that create, contribute to, and address quality of life issues within rural communities. Rural refers to all territories, populations, and housing units located outside of urbanized areas and urban clusters with fewer than 50,000 residents (U.S. Census Bureau, 2010). Rural communities face various environmental barriers such as lack of access to services, limited funding, fewer resources, and fewer development projects for the improvement of systems. Disparities exist in rural communities as they relate to these innate challenges that affect sufficient provision of social services (Lewis, Scott, & Calfee, 2013). When assessing social services such as food, shelter, and security in rural communities, supply and demand for services are inconsistent within the residing population. In addition, the poverty rate in rural America is higher than in urban areas; rural residents must travel long distances to access health care, and a heavy reliance is placed on practitioners.

As stated in the National Association of Social Workers Code of Ethics (NASW) (1999), social workers can intervene with rural communities through direct practice, community organizing, supervision, consultation administration, advocacy, social and political action, policy development and implementation, education, and research and evaluation. The profession expects efforts that “strive to ensure access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people” (p. 5) which supports their value of community research within rural areas to address issues of health disparities. Community research within rural areas contributes to increased practitioner competency and knowledge base about issues related to health and how practitioners can better serve the population.

Over many years, research has explored the need for better quality health care in rural America. Specific to social work, scholars have explored disparities between urban and rural geographical regions for as long as the issue has existed. According to Lewis, Scott, and Calfee (2013), rural social service disparities are presented in relation to key challenges surrounding the provision of social work services in the rural United States (p. 101). Belanger and Stone (2008) conclude the observation of the limited services in rural communities compared to urban communities:

Statistically significant differences between urban and rural counties were found for the following services: substance abuse treatment for children and teens; residential treatment for children and teens; school social work; afterschool programs for youth; and tutoring, mentoring, and enrichment for children. Fewer services considered critical to the welfare of children exist in rural counties. (p. 10)

The availability to services was significant as “urban counties had significantly higher availability/ accessibility for all services combined, than rural counties” and counties with “larger populations enjoy greater total accessibility to services” (Belanger & Stone, 2008, p. 11).

Historically, rural communities have encountered barriers to accessible services. Local residents of the community travel to access certain services that are not available in their community. Limited financial access has contributed to the limited resources that are accessible for rural communities.

As the U.S economy has contracted, funding of social service by government and private sources has similarly decreased. For rural communities, this often means that, instead of a reduction in services, the geographical boundaries for the provision of social service increase. (Lewis, Scott, & Calfee, 2013, p. 101)

As government and private source funding decreases, the geographical boundaries for the provision of services widens creating more difficulties for rural communities to pursue and obtain access to immediate health services. The geographical boundaries also create an unfeasible opportunity for rural community members to easily access much needed health resources in adjacent urban areas. More innovative approaches can serve to “link limited social service resources with established community institutions like schools and churches” (Lewis, Scott, & Calfee, 2013, p. 102). These scholars further emphasize that “federal and state governmental agencies and community organizations are forced to take on the challenge of collaboration for the purposes of improved program efficiencies and outcomes without any additional cost” (p. 102). These collaborative efforts create effective outcomes on rural community initiatives.

Some studies have explored the more traditional focus of health initiatives and compared them to newer initiatives of health within rural communities (Hartley, 2004). As limited health services are evident, the direction of health initiatives have placed “its attention toward population health, public health, and the differences between urban and rural health behaviors,” rather than services (p. 1675). The term used is population health, an approach that focuses on a number of interrelated factors that affect the health of the community and new policy intervention approaches have begun to emphasize this method to reaching rural populations.

Methodology

This study examines the adequacy of health services through the use of a mixed methodological approach. The research design assessed responses from a pre-developed questionnaire which contained two qualitative questions and seven quantitative questions. The sample size of 361 participants consisted of persons who lived and/or worked within a rural community. Although participants were asked to rank and rate various areas of education, safety, and social services, this study focuses on the data that assessed the health and mental health services within a rural community. Additional data collection of demographics was categorized for analysis including age, gender, ethnicity, race, marital status and total years of residing and/or working in the community. The majority of participants were white (49%; n = 178), female (62%; n = 224), and 22 to 30 years of age (32%; n = 114). They were mostly married (48%; n = 158) with roughly 43 percent (n = 156) having lived and/or worked in a rural community for over 10 years.

The primary focus of this study assessed the correlation between age and perception of overall community health with the following hypotheses:

H₁: Participants who are older will be more likely to rate overall community health as somewhat healthy or not healthy.

H₂: The perceptions of older-aged participants will be different than the perceptions of younger participants.

H₃: The age of participants does influence the perception of overall community health.

Results

Data for the rating portion are analyzed for the health of the following areas: safety services, childcare services, physical health services, housing services, mental health services, transportation services, and social services. The ratings are identified on a scale of 1 (healthy), 2 (somewhat healthy), and 3 (not healthy). Participants rated the overall health of the community pertaining to each area. All of the areas indicated more than 40 percent of each of the areas was either somewhat or not healthy at all. Only a little over half of participants rated education services in the rural community as healthy (56%; n = 161) with remaining areas being rated as somewhat healthy or not healthy at all: safety (53%; n = 168), childcare (55%; n = 161), physical health (70%; n = 108), housing (69%; n = 110), mental health (70%; n = 108), transportation (73%; n = 96), and social services (74%; n = 94).

Data using the same sample size also analyzed which areas participants identified as needing the most assistance in rural communities in which they lived. Based on the participants’ experiences, the needs of the community were ranked from 1 (needs most assistance) to 8 (needs the least assistance). Results indicated social services was identified as the area with the highest need for assistance (35%; n = 126). Overall, the remaining areas were all identified to a certain extent as an area that needed the highest attention within rural areas: childcare (26%; n = 94), transportation (24%; n = 89), housing (23%; n = 82), mental health (23%; n = 82), education (21%; n = 76), physical health (18%; n = 66), and safety (14%; n = 53). These results support the need for additional resources within rural communities at all levels.

Although no differences by ethnicity were indicated, other differences between groups based on gender and age were observed. Using an independent samples t test, the mental health rating was statistically significant across age groups (p < .01; p = .007) with 82 percent (n = 153) of participants between ages 31 to 70 years expressing more concerns about mental health in rural areas compared to 61 percent (n = 104) of participants 18 to 30 years of age. The gender of participants showed statistically significant differences (p < .01; p = .015) in how they ranked physical health with a third of the males (26%) indicating physical health as an area that needed the highest attention compared to the 16 percent of the female participants. Lastly, results also indicated statistically significant differences (p < .05; p = .042) of physical health across the different age groups with 38 percent of participants 18 to 30 years of age indicating physical health as an area that needed the highest attention compared to 27 percent of participants above the age of 30 years.

Overall, all three hypotheses were accepted. The older population aged 51 years and older was more likely to rate childcare services and safety services within the community as either somewhat healthy or not healthy compared to participants 18 to 21 years of age. Almost 58 percent (n = 45) of older participants indicated childcare services were not healthy compared to 40 percent (n = 24) of younger participants and 55 percent (n = 43) of older participant indicated safety services were not healthy compared to 47 percent (n = 28) of younger participants. These findings emphasize the perceptions between older and younger participants are different as it relates to particular areas within rural communities. Age yielded statistically significant correlations with social services (p = .016) and mental health services (p = .005). There was a positive correlation between the age and social services, r = .128, p = < .05, and there was a positive correlation between age and mental health, r = .147, p = <.01.

Discussion

As with other studies,these findings stated above reflect previously substantiated concerns from participants in rural areas and the services they think are not adequately provided within the community. Social services were high for needing assistance and low for being healthy. This discovery through data proves that social services in the rural community are not fulfilling the community needs and recommendations are beneficial concerning improvements to agencies, organizations, and policies. The majority of the participants are community members who have resided in the rural community for over 10 years and are between the ages of twenty-two to thirty years. This fact supports inadequacies of services that are identified by community members who have resided in a rural community long enough to recognize the needs.

More importantly, the role of age plays an integral part in the observations identified as needs within rural communities. As government and private source funding has decreased, the geographical boundaries for the provision of services has widened. The elderly population in rural communities has always been underserved and deemed vulnerable. As the elderly population increases the demand for all services will increase. The role of social workers is vital in the advocacy efforts of providing education and awareness for accessible resources within rural communities. The role of helping professionals emphasizes “access to needed information, services, and resources; equality of opportunity; and meaningful participation in decision making for all people” (NASW, 1999). Social workers must actively participate in advocating for the allocation of adequate resources within rural communities. The responses from participants eighteen to thirty years are beneficial to research, as their observations provide another lens to limited resources of consideration for rural communities. Such involvement from even younger participants can support utilization of a “bottom up approach” to community research, because this population is generally overlooked with little contribution to community development (Goodwin & Young, 2013). Involving more youth provides a “vast and often untapped resource for contributing to immediate and long-term community development efforts’’ (Brennan, Barnett, & McGrath, 2009, p. 309).

Implications for Social Work Practice

As community efforts toward social change persist, ensuring that all participants within rural communities have a voice is vital. Not only is the perspective of middle-aged adults important, but also inclusion of the younger and older populations provides valuable insight into identifying resources to help address the healthy services in rural communities. Because “rural populations generally experience disproportionate deficiencies or fragmentation in health care access, social services, and other goods and services needed for healthy living, adding to the perception of ineffective encounters with formalized programs” (Averill, 2002, p. 450), research efforts must be used to support political advocacy efforts to increase financial capital in rural communities. Enhanced educational awareness, improved communication between systems and communities, and adequate delivery of services amongst system representatives can influence a healthy community perception of the available services. Increasing awareness to social workers in rural communities helps adequately prepare residents for any expansion of services within the community as social work practitioners are trained to assess population growth as well as advocating at the legislative level for policy development that focuses on building financial and social capital. Also, with the continuance of evidence-based research practices, social workers gain an increased knowledge and competency that assist in providing solutions to improve systems serving rural communities.

References

*Sponsoring Statement from Faculty Supervisor:

The planning, execution, and writing of this manuscript represent primarily the work of both of the mentioned undergraduate students (Danielle Mitchell and Paulichia Woody) with assistance from myself in the area of editing, formatting, and data analysis.