Rural men and rural women are more likely to join the military than their urban counterparts—the VA Office of Rural Health reports that they are 22 percent more likely to join the Army. And they return home with significantly greater health and mental health needs, and with less access to treatment, including treatment for chronic hypertension and post-traumatic stress disorder. But men and women returning from combat often face other problems, as well. They return to children and families that have reorganized around their absence. They return to rural communities that are in poor labor markets, to friends who no longer relate to them, and to everyday activities that now seem trivial.
In addition, children and families of veterans face their own challenges both during the veteran’s deployment and upon their return home. They have lost a parent or spouse, even if only temporarily, and suffer grief and loneliness, and possibly even anger or feelings of desertion, which can lead them to exhibit school problems or depression.
In previous Rural Monitor articles, I discussed the meaning of rural human services, and the importance of human services for self-sufficiency, health and happiness, and to prevent even greater problems. We know, however, that not only basic health services are less available in rural areas, but human services are also less available and at times unavailable.
The Veterans Administration understands the importance of human services; social workers (the profession most responsible for the delivery of human or social services) work in all VA hospitals and centers. VA social workers help veterans apply for benefits, access community services and find resources for housing. They provide help for marriage or family problems, for stress due to health or medical conditions, for veterans overwhelmed with childcare, and help or referrals for drinking or drug use. They can help veterans in crises, coordinate services, and even advocate for more help for the veteran or his/her family.
But because VA hospitals and centers are located, for the most part, in urban areas, VA social workers are rare in rural America, where veterans are disproportionately overrepresented. To make matters worse, other human services may also be absent in rural communities. When Scott Allard and Jessica Cigna analyzed the safety net in the rural West, they found serious gaps in safety net services in many rural areas, non-profit organizations often dependent on government grants and Medicaid, and “local safety nets that are less reliable for those seeking help and that may suddenly place the burden of unmet community needs on other already overworked community organizations.” The return of veterans to their rural communities further stresses the very limited resources there.
One solution to rural health deficits has been the Internet. Telehealth has been developed to increase access to assessment and treatment and the Veterans Administration has increased services and personal health information available on the Internet. But human services are particularly difficult to provide at a distance. Even finding the kinds of social services a rural warrior might access proved challenging for me. An Internet search located several organizations whose missions are to provide information to veterans or their families, but their help appeared to be more targeted to population centers where services do exist. But even more challenging is the finding by McInnes and his colleagues that rural veterans accessed the Internet significantly less for health than their urban counterparts.
There are several unique and fascinating programs that provide services to rural veterans through specific outreach efforts. For example, the Veteran Farmers Project, organized by the Center for Rural Affairs, offers personalized professional consultations on farm production, business and financing to veterans in Colorado, Kansas, Missouri and Nebraska. The Family Assistance Center of Marshall, Minn., is collaborating with the Southwestern Center for Independent Living to bring professional services to rural communities in southwest Minnesota. Lake County Vet Connect brings together rural veteran volunteers, representatives from community health and human service providers, and representatives from the Clearlake VA Community-Based Outpatient Clinic and San Francisco VA Medical Center to offer access to care and services, information, and informal support to rural Veterans and their families.
While these are individual community efforts, or collaborations among organizations, Minnesota has sponsored an effort to encourage communities to care for veterans and their families. The Beyond the Yellow Ribbon Campaign encourages communities in Minnesota to create a “sustainable action plan demonstrating their commitment to Service members and military families.” Their family assistance centers in now 31 Yellow Ribbon cities sponsor “Strong Bonds Marriage Retreats” and “Family Reintegration Academy” along with information about youth activities and parental assistance. The services are provided with and through the communities locally, while their linkage provides support for all the centers through fundraising, corporate engagement and promising practice models of help.
Unfortunately, such services do not exist in many rural communities. Where they do exist, some rely on time-limited grants, and others may not be sustainable, particularly those solely helping returning Iraq and Afghanistan veterans and their families. However, by providing multiple levels of care for veterans, perhaps the centers described above can serve as examples, and help rural communities find sustainable ways to bring human services to all their members.
I would like the opportunity to learn more about the rural community-based efforts initiated across the country, particularly those that integrate veterans’ services locally in a sustainable, community-supported way. Please send your examples, along with the name of a person to me at the email address below.
Opinions expressed in this column are those of the author and do not necessarily reflect the views of the Rural Health Information Hub.
Back to: Winter 2012 Issue