Causes and Implications of the Opioid Crisis in Rural America

2020 ◽  
pp. 46-74
Author(s):  
Bita Ashouri Rivas ◽  
Anthony L. Rivas
Keyword(s):  
Rural Communities ◽  
War On Poverty ◽  
Rural America ◽  
Community Members ◽  
Historical Trends ◽  
National Crisis ◽  
Opioid Crisis ◽  
Related Substances ◽  
Level Of Use ◽  
Urban Rural

The purpose of this chapter is to outline the history and development of the opioid crisis; to identify impacts to rural America; to elaborate on the implications to individuals, families, and communities; and to identify resources for these communities. The level of use, misuse, and impact of opioids on communities has caught national attention and has been labeled a national crisis. The opioid epidemic has hit rural communities especially hard with community members citing opioid abuse as the biggest problem in their communities. To better understand the current epidemic, it is important to understand historical trends in relation to opioids and opioid related substances; the War on Poverty; the recession of 2007; job loss; and the shifting of urban/rural divide politically, financially, and economically. The flooding of opioids into these communities impacted every system, with layered consequences.

scholarly journals POLICY SERIES: ELDER ABUSE AND THE OPIOID EPIDEMIC IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S762-S762
Author(s):  
Brian W Lindberg ◽  
Robert Blancato
Keyword(s):  
Older Adults ◽  
Prescription Drugs ◽  
Elder Abuse ◽  
Multiple Chronic Conditions ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Rural America ◽  
Related Substance ◽  
National Crisis ◽  
Related Substances

Abstract Misuse of opioids is a national crisis affecting the social and economic welfare of communities throughout the U.S. and is particularly rampant in rural America. Older adults are far too frequently excluded from consideration of those who are affected by the opioid epidemic. While rural older adults may not suffer the highest per capita rate of opioid overdose deaths, they are deeply affected by the problem. In their youth and middle adulthood, many older adults used their bodies for labor. At older ages, they experience multiple chronic conditions and high rates of chronic pain for which opioids and related prescription and non-prescription drugs are often the treatment of choice. Also and far too frequently, older people become easy targets for abuse by persons needing resources to feed their addiction. This symposium focuses on elder abuse associated with opioid and related substance misuse. Zanjani’s presentation provides the context of rurality and drugs and alcohol as a precursor to elder abuse. The second paper by Teaster and colleagues examines trends in APS cases of elder abuse in which the perpetrator is a substance user and identifies perpetrator and victim characteristics predictive of different types of substantiated abuse. Using APS case notes, Roberto and colleagues characterize cases of elder abuse in rural Kentucky in which the perpetrator used opioids and related substances. Robert Blancato and Brian Lindberg will discuss presenters’ collective findings by weaving together concepts of rurality, addiction, and elder abuse and recommending strategies for prevention, intervention, and policy.

scholarly journals Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment

2021 ◽  
Vol 12 ◽  
pp. 215013272098771
Author(s):  
Heather Blue ◽  
Ashley Dahly ◽  
Susan Chhen ◽  
Julie Lee ◽  
Adam Shadiow ◽  
...  
Keyword(s):  
Pain Management ◽  
Rural Communities ◽  
Social Determinants Of Health ◽  
Emergency Medical Service ◽  
Social Determinants ◽  
Medical Service ◽  
Critical Role ◽  
Access To Treatment ◽  
Opioid Crisis

Introduction: The continuing opioid crisis poses unique challenges to remote and often under-resourced rural communities. Emergency medical service (EMS) providers serve a critical role in responding to opioid overdose for individuals living in rural or remote areas who experience opioid overdoses. They are often first at the scene of an overdose and are sometimes the only health care provider in contact with an overdose patient who either did not survive or refused additional care. As such, EMS providers have valuable perspectives to share on the causes and consequences of the opioid crisis in rural communities. Methods: EMS providers attending a statewide EMS conference serving those from greater Minnesota and surrounding states were invited to take a 2-question survey asking them to reflect upon what they believed to be the causes of the opioid crisis and what they saw as the solutions to the opioid crisis. Results were coded and categorized using a Consensual Qualitative Research approach. Results: EMS providers’ perceptions on causes of the opioid crisis were categorized into 5 main domains: overprescribing, ease of access, socioeconomic vulnerability, mental health concerns, and lack of resources and education. Responses focused on solutions to address the opioid crisis were categorized into 5 main domains: need for increased education, enhanced opioid oversight, increased access to treatment programs, alternative therapies for pain management, and addressing socioeconomic vulnerabilities. Conclusion: Along with the recognition that the opioid crisis was at least partially caused by overprescribing, rural EMS providers who participated in this study recognized the critical role of social determinants of health in perpetuating opioid-related harm. Participants in this study reported that education and increased access to treatment facilities and appropriate pain management, along with recognition of the role of social determinants of health in opioid dependency, were necessary steps to address the opioid crisis.

scholarly journals Working with community researchers to enhance rural community engagement around Private Water Supplies: an exploration of the benefits and challenges

2020 ◽  
pp. 146879412097888
Author(s):  
Rachel Creaney ◽  
Mags Currie ◽  
Paul Teedon ◽  
Karin Helwig
Keyword(s):  
Rural Communities ◽  
Community Engagement ◽  
Rural Community ◽  
Methodological Approach ◽  
Good Practice ◽  
Duty Of Care ◽  
Community Members ◽  
Water Supplies ◽  
Employment Opportunities

This project employed community researchers as a means of improving community engagement around their Private Water Supplies (PWS) in rural Scotland. In this paper, we reflect on working with community researchers in terms of the benefits and challenges of the approach for future rural research that seeks to improve community engagement. The paper (1) critiques the involvement of community researchers for rural community engagement, drawing on the experiences in this project and (2) provides suggestions for good practice for working with community researchers in rural communities’ research. We offer some context in terms of the role of community members in research, the importance of PWS, our approach to community researchers, followed by the methodological approach and findings and our conclusions to highlight that community researchers can be beneficial for enhancing community engagement, employability, and social capital. Future community researcher approaches need to be fully funded to ensure core researchers can fulfil their duty of care, which should not stop when data collection is finished. Community researchers need to be supported in two main ways: as continuing faces of the project after the official project end date and to transfer their newly acquired skills to future employment opportunities.

Should a Special Educator Entertain Volunteers? Interdependence in Rural America

1984 ◽  
Vol 50 (4) ◽  
pp. 361-366 ◽  
Author(s):  
Lawrence W. Marrs
Keyword(s):  
Rural Communities ◽  
Service Delivery ◽  
Independent Living ◽  
Disabled Persons ◽  
Delivery Systems ◽  
Special Educator ◽  
Rural America ◽  
Volunteer Program ◽  
Service Delivery Systems ◽  
And Training

Rural communities have a tradition of helping each other and of shared interdependence. The National Rural Independent Living Network is developing Community Independent Living Service Delivery Systems in over 500 communities by 1986. Strategies are provided for designing a volunteer program, recruiting and training volunteers, and linking volunteers with disabled persons.

An Evaluation of the Differences between Big City and Small Town Special Education Services for Students with Low Incidence Disabilities in Kentucky

2009 ◽  
Vol 28 (4) ◽  
pp. 3-9 ◽  
Author(s):  
Robert Pennington ◽  
Channon Horn ◽  
Amy Berrong
Keyword(s):  
Special Education ◽  
Rural Communities ◽  
Special Education Teachers ◽  
Demographic Data ◽  
Educational Programming ◽  
Rural America ◽  
Rural Districts ◽  
Rural Settings ◽  
Big City ◽  
Low Incidence

Researchers have suggested that educational programming for students with low incidence disabilities in rural settings may be limited. In the current study, researchers surveyed special education teachers across Kentucky and collected demographic data on two exemplar districts. Results indicated that differences existed between urban and rural districts on several variables but that some rural communities in Kentucky were able to overcome barriers to the provision of educational programming for students with low incidence disabilities prevalent in other parts of rural America.

scholarly journals Economic valuation of water services related to protected forest management: a case of Bukit Batabuh in the RIMBA corridor, Central Sumatra, Indonesia

2021 ◽  
Author(s):  
Barano Siswa Sulistyawan ◽  
Budy P. Resosudarmo ◽  
Rene W. Verburg ◽  
Pita Verweij ◽  
Mia Amalia ◽  
...  
Keyword(s):  
Forest Management ◽  
Rural Communities ◽  
Riparian Forest ◽  
Economic Valuation ◽  
Water Storage ◽  
Water Services ◽  
Community Members ◽  
Water Storage Capacity ◽  
Tropical Forest Management ◽  
Central Sumatra

AbstractThe context of daily household needs of rural communities, particularly the needs for water, often remains insufficiently considered in tropical forest management as it is facing an important decision-making trade-off between profit and preservation. We conducted a choice experiment study to elicit preferences of the rural community members in Central Sumatra, Indonesia, who perpetually depend on the ecosystem services of tropical forests. To inform a spatial planning policy for the protected forest, we focus on the valuation of water services in the protected forest area of Bukit Batabuh where the surrounding communities living rely on upstream watershed and water storage management. We find that those communities have a strict preference for improving forest water provisioning services, compared to the current situation (status quo), with the estimated aggregate benefit of non-commercial use ranging between USD 2.71 million and USD 2.47 million per year for each of the options of (1) maintaining and enhancing water storage, (2) rehabilitating forest in the upper watershed or (3) restoring the riparian forest. This study also identifies preference attributes, such as water storage capacity, water scarcity and water turbidity which can be used in other tropical landscape contexts in Indonesia and beyond.

scholarly journals Food Insecurity in Households of People with Autism Spectrum Disorder during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Vijay Vasudevan ◽  
Arun Karpur ◽  
Andy Shih ◽  
Thomas Frazier
Keyword(s):  
Autism Spectrum Disorder ◽  
Rural Communities ◽  
Food Insecurity ◽  
Free Food ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Convenience Sample ◽  
Urban Rural ◽  
Federal Response ◽  
Us Census

AbstractObjectivesTo explore differences in food insecurity for individuals and families of people with autism spectrum disorder (ASD) during the COVID-19 pandemic by individual, family, and neighborhood characteristics.MethodsWe surveyed a convenience sample of households of people with ASD. We calculated food insecurity using items from the US Census Bureau’s Household Pulse Survey..ResultsOver half of all respondents reported being food insecure (51.8%). Respondents who reported being food insecure were more likely to be minority, have a high school education or less, be on public insurance or uninsured, live in urban/rural communities, and say that their community is not supportive. The majority of respondents did not get free food or groceries (53.2%). Food insecure respondents who got free food was most likely to get them from schools (34.2%).ConclusionThis is the first study of its kind to explore food security in households of people with ASD. The pandemic has exacerbated existing neighborhood disparities. The federal response to food insecurity caused by the pandemic needs to be further explored especially for preferred and medically necessary foods for people with ASD.

scholarly journals Addressing climate change from a social development approach: Small cities and rural communities’ adaptation and response to climate change in British Columbia, Canada

2016 ◽  
Vol 60 (1) ◽  
pp. 61-73 ◽  
Author(s):  
Julie Lynne Drolet ◽  
Tiffany Sampson
Keyword(s):  
Climate Change ◽  
British Columbia ◽  
Rural Communities ◽  
Social Development ◽  
Social Workers ◽  
Community Members ◽  
Small Cities ◽  
The Social ◽  
Development Approach ◽  
Impacts Of Climate Change

Climate change is having a very real impact, affecting not only ecosystems but also the socio-economic systems of small cities and rural communities. Globally, climate change is a consequential concern, since it is contributing to an increase in global temperatures, changing precipitation patterns, raising sea levels, and natural hazards. Locally, the effects of climate change vary, depending upon the region, with communities experiencing the impacts of climate change differently and at various degrees. This article presents research findings from a study on climate change, disasters, and sustainable development that provide insight into the diverse perspectives of community members on climate change in six communities in the Interior and Northern regions of British Columbia, Western Canada. A common denominator between these six communities is how social development is being applied to address climate change. The concept of social development encompasses social and economic well-being. The social development approach involves processes, activities, and institutions working together to develop the social and economic capacities of individuals and communities. In particular, for social workers working with individuals, families, and communities impacted by climate change, the social development approach is effective in addressing social and economic needs. This article will examine the differing perspectives and attitudes of affected community members and the role of social development with respect to climate change adaptation and response. It will also provide suggestions on how social workers can support and apply the social development approach in communities experiencing the impacts of climate change.

scholarly journals Validation of a digitally displayed photographic food portion-size estimation aid among women in urban and rural Malawi

2019 ◽  
Vol 22 (17) ◽  
pp. 3140-3150 ◽  
Author(s):  
Valerie L Flax ◽  
Chrissie Thakwalakwa ◽  
Courtney H Schnefke ◽  
Heather Stobaugh ◽  
John C Phuka ◽  
...  
Keyword(s):  
Rural Communities ◽  
Low Income ◽  
Portion Size ◽  
Size Estimation ◽  
Individual Level ◽  
Low Income Country ◽  
Urban Rural ◽  
Highly Correlated ◽  
The Individual ◽  
Portion Size Estimation

AbstractObjective:To validate digitally displayed photographic portion-size estimation aids (PSEA) against a weighed meal record and compare findings with an atlas of printed photographic PSEA and actual prepared-food PSEA in a low-income country.Design:Participants served themselves water and five prepared foods, which were weighed separately before the meal and again after the meal to measure any leftovers. Participants returned the following day and completed a meal recall. They estimated the quantities of foods consumed three times using the different PSEA in a randomized order.Setting:Two urban and two rural communities in southern Malawi.Participants:Women (n 300) aged 18–45 years, equally divided by urban/rural residence and years of education (≤4 years and ≥5 years).Results:Responses for digital and printed PSEA were highly correlated (>91 % agreement for all foods, Cohen’s κw = 0·78–0·93). Overall, at the individual level, digital and actual-food PSEA had a similar level of agreement with the weighed meal record. At the group level, the proportion of participants who estimated within 20 % of the weighed grams of food consumed ranged by type of food from 30 to 45 % for digital PSEA and 40–56 % for actual-food PSEA. Digital PSEA consistently underestimated grams and nutrients across foods, whereas actual-food PSEA provided a mix of under- and overestimates that balanced each other to produce accurate mean energy and nutrient intake estimates. Results did not differ by urban and rural location or participant education level.Conclusions:Digital PSEA require further testing in low-income settings to improve accuracy of estimations.

scholarly journals Ecosystem services and ecological degradation of communal wetlands in a South African biodiversity hotspot

2019 ◽  
Vol 6 (6) ◽  
pp. 181770 ◽  
Author(s):  
A. Owethu Pantshwa ◽  
Falko T. Buschke
Keyword(s):  
Ecosystem Services ◽  
Rural Communities ◽  
Sustainable Use ◽  
Biodiversity Hotspot ◽  
Ecological System ◽  
Governance System ◽  
Community Members ◽  
Personal Benefit ◽  
Administrative Area ◽  
Gender Based

Wetlands provide important ecosystem services to rural communities. However, wetlands are often on communal land, so they may become degraded when individual users act to maximize their personal benefit from ecosystem services without bearing the full environmental costs of their actions. Although it is possible to manage communal resources sustainably, this depends on the dynamics of the socio-ecological system. In this study, we used a structured questionnaire to examine whether demographic characteristics of a rural community and the propensity for partaking in damage-causing activities affected the benefits obtained from the wetlands. Responses from 50 households in the rural Hlabathi administrative area within the Maputo-Albany-Pondoland Biodiversity Hotspot, South Africa, indicated that the entire community obtains some benefits from wetlands; most notably regulating ecosystem services. However, males were more likely to benefit from wetlands, which highlights a potential power imbalance. Respondents were more likely to blame others for wetland degradation, although there was no link between the damage-causing activities and benefits from wetlands. The high dependence on ecosystem services by community members, when combined with gender-based power imbalances and the propensity to blame others, could jeopardize the sustainable use of communal wetlands. Therefore, we describe how strong leadership could nurture a sustainable social–ecological system by integrating ecological information and social empowerment into a multi-level governance system.

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