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Rural Health Information Hub

Feb 21, 2013

Rural Human Services: We've Come So Far and Have So Far to Go!

or Human Services columnist

by Kathleen Belanger

I can distinctly remember the launch of the Rural Assistance Center (RAC) in December of 2002 (renamed Rural Health Information Hub 12/15). At the time I chaired the National Advisory Committee on Rural Social Services of the Child Welfare League of America (CWLA). Our committee had been in existence only a few years and we realized that one of the greatest challenges we faced was the collection and dissemination of information about rural child welfare. Where was the research? Is rural the same as urban, or do we need to teach social workers in rural areas different skills, different practice methods? CWLA asked us to gather information, to pose the question to researchers, and to publish a special issue devoted to rural child welfare, which of course includes human services. In September 2002, The Crisis in Rural Child Welfare (no longer available online) was published. Asking for and gathering research was only a start.

When we met the following spring, and received the first brochures about RAC, we thought the world had finally changed. Here was a single Internet “place” that opened the field of rural health and human services to us. We could access maps that showed us what rural meant to different groups, and particularly to different parts of the government. We could begin to develop a language based on rural health language, and to see solutions that were generated by rural communities for pressing problems that we all shared. We could access grants, and could see the efforts of foundations in rural communities. And we who wear so many local hats and cross so many systems no longer had to do our own laborious searches, but could simply link to the RAC. At its annual conferences, CWLA gives presentations on rural cultural competence, and includes information on RAC: how users can find resources by topic, use the State Guides to find updates and news releases in their own states, or find conferences they might want to attend. In 2009 we provided an interactive roundtable for all public child welfare administrators using the Am I Rural? tool; administrators found information they had never before accessed.

Certainly, RAC provides an essential service in publicizing what we do know about rural human services. However, we are still far behind our rural health colleagues. We have a hard time defining and measuring rural human services, and even more difficulty understanding not only what is available in which communities, but what ought to be available. The problem is that research and evaluation are directed not by national questions, but by questions posed by specific researchers for a specific purpose. Even national questions are posed within “silos,” often with a weak link to policy. For example, the Fourth National Incidence Study of Child Abuse and Neglect (no longer available online) found that rural children experienced higher rates of maltreatment than urban children in nearly every category of maltreatment. The study also found significant linkages between maltreatment and poverty, substance abuse, unemployment and lower levels of education—all challenges in rural communities.  But what exists in rural communities for prevention and/or treatment? What impact do SNAP, rural health programs or rural development have on rural maltreatment or the factors related to maltreatment? Can a single worker in a rural community provide a cross section of the community's needs rather than multiple workers who only visit the community? It is difficult to construct policies without a better understanding of what is actually happening on the ground, and with what results for children and families.

I have recently been reading several articles and reports written by Marco Segone, Senior Evaluation Specialist for UNICEF. Segone, editor of New Trends in Development Evaluation, has been active in developing the concept of “country-led evaluations” (CLE). These are evaluation methodologies in which the country itself leads the evaluation process in order to better inform policy. The country engages the key stakeholders, and works with them to identify the programs and policies to be evaluated, questions to be asked, choice of methodology and analytical approaches and the ways in which the findings will be used.

Perhaps evaluation work with other nations is relevant to developing integrated policies for rural America. The current fragmented approaches to work in rural communities, fragmented approaches to problem solving, and fragmented approaches to program evaluation, lead to scattered pieces of information and varied research that is simply not as useful as it could be, and is difficult to navigate, even with the Rural Assistance Center's help. Instead of multiple agencies, multiple programs, multiple states, and multiple sites monitoring multiple approaches to solving variations of the same problems, we could consider a unified approach to policy, practice, and to evaluation. Instead, perhaps we should consider rural human services as a whole.

While we have come a long way in understanding rural health, and while we have come a long way in recognizing the need for a focus on rural human services, our understanding and policies for human services have lagged significantly behind health services. We need an Office of Rural Human Services. Government and its stakeholders—its citizens and rural constituents, along with the many agencies who try to provide human services in rural communities—need a centralized office to plan, coordinate, collect information—to monitor and evaluate what currently is being provided across all programs, to determine the impact of these efforts on those we are attempting to help, and on our communities, to inform public policy. Segone's recommendations for developing nations should be heeded by our own government.

As Archimedes said, “Give me a place to stand on, and I will move the Earth.” We have the Rural Assistance Center. We have an Office of Rural Health Policy. Now we need a place for human services to stand. We need an Office of Rural Human Services.

Kathleen Belanger, Ph.D., is Professor of Social Work at Stephen F. Austin State University in Nacogdoches, Texas, and is a member of the RUPRI Human Services Panel, and recipient of CWLA's Champion for Children award in 2005 for her work in rural child welfare. Belanger has published and presented on rural 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.

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This article was posted in Challenges for Human Services and tagged Child welfare ยท Human services