In the past several years there have been many discussions about food deserts, or places in which nutritious food is unavailable. According to the United States Department of Agriculture, in 2006, 2.3 million people lived in rural food deserts, low-income rural areas more than 10 miles from a supermarket. While the discussion of food deserts in rural America is something familiar to many of us, perhaps we should also be considering “human services deserts.”
Last week I was helping to plan a conference at Stephen F. Austin State University in Nacogdoches, Tex., on the ways in which faith can help in the grieving process. One of the physicians had just returned from a lecture and learned from the speaker that many times patients’ thanks to their physicians are not for health care, but for the physicians simply listening when they are experiencing grief. But with several physician friends and family members, I also understand the constraints the medical community faces. With costs and new obligations facing health care, there may not be time to spend “simply” listening.
In the same week, I also visited with a deeply concerned rural pastor. He was delighted that the county was engaging in juvenile drug court as a way of diverting youth from the criminal justice system to local rehabilitation. However, the county in which he is a pastor had no social service or counseling staff housed there, and churches will be considered the places of intervention for these youth. While pastors have training in counseling, rural pastors generally have either outside employment and/or other churches in their charge. This county, like many rural high-poverty counties, also has many other needs, and few people to meet them. His congregation was already overwhelmed trying simply to provide a food pantry for those in need, and he was the pastor for a much larger congregation in another county. He wanted to be of help to the youth in such desperate need. What was he to do?
Taking more time to simply listen may be outside of the scope of consideration for already pressed doctors and nurses, and working with youth attempting to free or divert themselves from a life of addiction may be beyond the capacity of local churches. However, social workers are trained (and licensed) to not only listen, but to assess, to help create plans for an individual, family and support system, which may include interventions beyond the scope of medicine or which are too time-consuming or skilled for volunteers. But these interventions may be the very ones that are indicated for not only prevention, but for treatment. They may be the interventions specifically linked to reducing recidivism, either in health or criminal/juvenile justice. Listening to those in grief may prevent depression, hospitalization and suicide. Helping people in stress think about personal strengths, possibly return to faith communities, or to reestablish bonds with family are all methods utilized to reduce reentry into the justice system or into more expensive residential care systems.
In the Fall 2012 Rural Monitor, I discussed the importance of “Boots on the Ground,” or having at least one full-time human services or social work public employee in each county. Instead of considering human services as something desirable, human services (social work) should be considered an essential element of the infrastructure, of the safety net. However, according to the Government Employment and Payroll reports of the U.S. Census (2011), of the counties responding in the report, between one-fourth to one-third with a population of fewer than 20,000 people have no “government welfare workers,” the category of the report that includes all public employment in human services at the local, state or federal levels. In other words, between one-fourth to one-third of all counties with a Rural Urban Continuum Code of 6 through 9 are, in effect, human services deserts.
Human services deserts really need at least one professional, publicly paid social worker. All of these ways of assisting, of providing human services support, are included in the skill sets of social workers. Assisting veterans as they cope with shock and wounds from war are part of the assessment, intervention and evaluation skills of social workers. Determining ways to obtain healthy foods, to link to sustainable systems, to find and build upon family strengths, are all part of the curriculum for all accredited social work programs. Social workers are educated to work with diverse racial and ethnic populations, to build non-profit organizations, to assist a variety of age groups and populations—including children, teens, families, the elderly, and people with special needs, and to deal with family violence. They work in schools, in hospitals, in court systems and probation, in public child welfare offices, and in hospice settings. And yet, between one-fourth to one-half of all counties with fewer than 20,000 persons have no publicly paid social worker, i.e., a “government welfare worker.” Providing a “spring” of assistance for every human services desert is a government policy worth considering as a cost-effective method of building an infrastructure for prevention, treatment, and community sustainability—which might even provide the infrastructure that would help eliminate rural food deserts, as well.
Kathleen Belanger, Ph.D., is Associate Professor of Social Work at Stephen F. Austin State University in Nacogdoches, Texas, and is a member of the RUPRI Human Services Panel, co-chair of Child Welfare League of America (CWLA) National Advisory Committee on Rural Social Services, and recipient of CWLA’s Champion for Children award in 2005 for her work in rural child welfare. Belanger has published and presented on human services issues in a variety of publications and forums. In addition, she has worked for more than 20 years with rural communities, where she has helped found several non-profit organizations and advocated for rural resources.
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: Spring 2013 Issue