Coronavirus in rural America (Part CII): "Rural is left out of the conversation"

That's a quote from this 14-minute segment on NPR this afternoon, a segment in which two rural nurses are interviewed.  The statement was made by one of the nurses, but there's no opportunity made/taken to unpack what she means by that.  Does it mean public health messaging has not been culturally sensitive?  that these rural nurses don't have the PPE that they need?  that the sense of rural disenfranchisement associated with how rural folks have been voting recently spills over into the public health arena?  I'm not sure.  

In any event, both nurses lament that so many of those they serve don't believe the coronavirus is "real" and many refuse to wear masks.  One disclosed that her husband, a welder, had expected coronavirus to go away on November 4.  In other words, he thought it was a hoax, even as he sees how she is struggling with work and what she is dealing with there.  

Keep an eye out for when the transcript of this is posted so you can read the entire interview.  

There's lots of other rural COVID 19 news to peruse.  Here's another NPR story, this one out of rural Kansas, about public health officers resigning and retiring because of public hostility.  James McLean reports. 

In July, Nick Baldetti resigned as director of the Reno County [population 64,511] Health Department in Kansas.

But it wasn't the 80-hour workweeks that drove him to quit, it was the hostile political environment and threats to Baldetti's family.

"I had the local police watching my house because my family was home and I was not," said Baldetti, who also served as the department's health officer. "There was a period of time that I had escorts to and from work."

Baldetti spent years preparing to deal with a public health crisis like the COVID-19 pandemic. He never imagined that when the moment arrived, he would encounter such antagonism for simply doing his job.

"By the end of the day, you just felt like you were on an island by yourself," he said. "Whatever decision I made, 50% of people were going to be upset because it was too 'restrictive' and the other 50% were going to be upset because it wasn't restrictive enough."

Here's a story from last week about a strained rural women's health clinic in Brownwood, Texas, population 19,288, in the central part of the Lone Star State.  Reporting is by Shannon Najmabadi of the Texas Tribune.  The story is only marginally about the pandemic--the point being that this clinic, unlike urban counterparts, can't "pivot" to telehealth.  An excerpt follows:

Women come from more than one hundred miles away to Building 35 in a red brick public housing project in rural Brown County, a housing unit turned health clinic where virtually every item, even the beige exam tables, is donated.

The clinic is walk-in only — no appointments — a better bet for patients with unreliable transportation or unpredictable schedules. Without federal funds, Midway Family Planning in Central Texas would have shut its doors long ago, its director says, as state budget cuts dried up family planning dollars from the Gulf Coast to the Texas Panhandle.

Instead, the nonprofit clinic has endured as a small health care lifeline, where low-income and uninsured Texans — far from busy cities with many doctors — can get free or low-cost contraceptives, cancer screenings and treatment for sexually transmitted diseases. 

* * *  

While clinics in cities like Dallas and Houston easily pivoted to telehealth visits to minimize face-to-face contact when the pandemic hit, that prospect makes Midway’s director, Carole Parker, laugh: Most of her patients don’t have access to stable internet connections.