Farmers and Health Care Reform: A Challenge and Opportunity for Extension

The Affordable Care Act (ACA) presents both opportunities and challenges for farmers. There is a great deal of variation in how states are implementing the ACA, which creates confusion for individuals and businesses trying to understand and evaluate health insurance options. To assist farmers and farm workers with navigating ACA reforms, Extension can work across program areas and leverage their network of farm technical assistance providers and non-profits to enhance outreach and program efforts. Extension tax schools and wider adoption of the Smart Choice Health Insurance - Farm Families can expand the portfolio of tools available for working with farmers

2007 Health Insurance Survey of Farm and Ranch Operators

Presents findings on the health insurance status of farmers and ranchers in the Great Plains states and the factors that raise their risk of spending 10 percent or more of their income on health care or reporting financial hardship due to medical costs

The Farming Population and Health Insurance: Educational Needs and Approaches of Extension Professionals

Health insurance policy has critical implications for farmers, who work in a dangerous occupation and have historically high rates of being uninsured and underinsured. Extension is well poised to respond to changing policies and provide outreach to agricultural communities. However, few studies have explored capacity within Extension to respond knowledgeably to health insurance–related opportunities. Accordingly, we conducted focus group sessions with Extension professionals to understand current efforts, resource needs, and opportunities for program development in this realm. Our findings revealed a need for knowledge building within Extension through programming collaboration and an opportunity to connect the agriculture and health insurance sectors. We also identified strategies for addressing the topic with farmers

The Double Disparity Facing Rural Local Health Departments

Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities

A Profile of Tribal Health Departments

This study uses data to analyze the impacts of Tribal health departments in improving health status and reducing health disparities.

KnudsonBureshAlana1998.pdf

Access to health care in North Dakota, a frontier state, has been a widely debated policy issue. Historically, the focus of North Dakota health policy efforts has been directed to issues pertaining to the provision of health care services. During the economic recession of the I 980s, an out-migration of North Dakota residents left the state with a smaller population in 1990 than it had in 1930, the only state to experience this population shift. In response to these demographic shifts, the North Dakota Health Task Force was formed to develop a health care reform strategy that addressed geographical and financial health care access issues. Over 2,000 North Dakota families were surveyed to provide the Task Force and other policy makers with information about North Dakota residents' health insurance coverage and health care utilization. The purpose of this research was to examine what variables impact access to health insurance coverage and utilization of health care services in North Dakota. Three access areas were addressed: financial, geographical and cultural. To examine financial access, health insurance coverage was examined. Among the non-institutionalized ND residents, the greatest proportion of uninsured were young adults; although, all North Dakotans were found to be at risk. The health insurance findings mirrored many other studies' findings in which males, part-time workers and rural dwellers were the most likely to go without insurance. In addition, health insurance appears to serve as a gatekeeper for obtaining health care services. A surprising finding was that geographic barriers were not a hindrance to obtaining health care. Yet, Native Americans covered by Indian Health Service were less likely to obtain health care than the uninsured indicating there may be some cultural barriers for this population. Other findings included: the uninsured go without health care and report lower health status more frequently than the insured; poverty level is positively correlated with health status; among those with no regular source of health care, the insured report they do not need health care while the uninsured report they cannot afford it. Comparisons of rural and urban dwellers also are included in the analyses

Knudson-Buresh, Alana1998.zip

Access to health care in North Dakota, a frontier state, has been a widely debated policy issue. Historically, the focus of North Dakota health policy efforts has been directed to issues pertaining to the provision of health care services. During the economic recession of the I 980s, an out-migration of North Dakota residents left the state with a smaller population in 1990 than it had in 1930, the only state to experience this population shift. In response to these demographic shifts, the North Dakota Health Task Force was formed to develop a health care reform strategy that addressed geographical and financial health care access issues. Over 2,000 North Dakota families were surveyed to provide the Task Force and other policy makers with information about North Dakota residents' health insurance coverage and health care utilization. The purpose of this research was to examine what variables impact access to health insurance coverage and utilization of health care services in North Dakota. Three access areas were addressed: financial, geographical and cultural. To examine financial access, health insurance coverage was examined. Among the non-institutionalized ND residents, the greatest proportion of uninsured were young adults; although, all North Dakotans were found to be at risk. The health insurance findings mirrored many other studies' findings in which males, part-time workers and rural dwellers were the most likely to go without insurance. In addition, health insurance appears to serve as a gatekeeper for obtaining health care services. A surprising finding was that geographic barriers were not a hindrance to obtaining health care. Yet, Native Americans covered by Indian Health Service were less likely to obtain health care than the uninsured indicating there may be some cultural barriers for this population. Other findings included: the uninsured go without health care and report lower health status more frequently than the insured; poverty level is positively correlated with health status; among those with no regular source of health care, the insured report they do not need health care while the uninsured report they cannot afford it. Comparisons of rural and urban dwellers also are included in the analyses

A study of health insurance coverage and health care utilization in North Dakota

Access to health care in North Dakota, a frontier state, has been a widely debated policy issue. Historically, the focus of North Dakota health policy efforts has been directed to issues pertaining to the provision of health care services. During the economic recession of the I 980s, an out-migration of North Dakota residents left the state with a smaller population in 1990 than it had in 1930, the only state to experience this population shift. In response to these demographic shifts, the North Dakota Health Task Force was formed to develop a health care reform strategy that addressed geographical and financial health care access issues. Over 2,000 North Dakota families were surveyed to provide the Task Force and other policy makers with information about North Dakota residents' health insurance coverage and health care utilization. The purpose of this research was to examine what variables impact access to health insurance coverage and utilization of health care services in North Dakota. Three access areas were addressed: financial, geographical and cultural. To examine financial access, health insurance coverage was examined. Among the non-institutionalized ND residents, the greatest proportion of uninsured were young adults; although, all North Dakotans were found to be at risk. The health insurance findings mirrored many other studies' findings in which males, part-time workers and rural dwellers were the most likely to go without insurance. In addition, health insurance appears to serve as a gatekeeper for obtaining health care services. A surprising finding was that geographic barriers were not a hindrance to obtaining health care. Yet, Native Americans covered by Indian Health Service were less likely to obtain health care than the uninsured indicating there may be some cultural barriers for this population. Other findings included: the uninsured go without health care and report lower health status more frequently than the insured; poverty level is positively correlated with health status; among those with no regular source of health care, the insured report they do not need health care while the uninsured report they cannot afford it. Comparisons of rural and urban dwellers also are included in the analyses