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Rural, Louisiana

Rural, Louisiana, photo shared by Karen Francis

Public Health Approach

The Public Health Approach to Rural Behavioral Health

Mental health is central to everyone’s  well-being, and is influenced by biological, social and economic factors. Developing comprehensive strategies to promote mental wellness and prevent mental and substance use disorders, as well as other behavioral health problems requires a public health approach across many systems, sectors and organizations to help enhance the protective factors that promote positive mental health, and implement strategies for early identification and interventions/treatment when challenges arise.  Additionally, a public health approach can guide the planning and implementation of strategies to reduce risks to the entire community and those populations within the community that may be at increased risk.  Rural communities vary widely.  A recent report from The Carsey Institue at the University of New Hampshire identified four distinct, often disparate, rural Americas.  The report, called “Place Matters: Challenges and Opportunities in Four Rural Americas,” [1] describes them broadly as:

  • Amenity-rich areas that draw vacationers, retirees, and second home-owners with their mountains, lakes, coastlines, or forests.
  • Declining resource-dependent areas that once thrived on the agriculture, timber, mining and manufacturing industries which, now threatened by globalization and resource depletion, no longer support a vibrant middle class population.
  • Chronically poor regions where residents and the land have suffered decades of resource depletion and underinvestment.
  • A transitional type characterized by amenity-driven growth and resource-based decline. While traditional resource-based economies in these areas have weakened, these transitional regions show potential for amenity-driven growth.

As one of the authors notes, “A one-size-fits-all approach to policymaking will not work, as each of these regions struggles with its own place-specific issues and problems, addressing the challenges in rural America requires an understanding of the complex changes happening right now in these very different regions in order to target their unique needs and opportunities.” [2] 

The Rural Behavioral Health of Children and Youth in Rural America is greatly impacted by place.  Chronically poor regions such as Mississipi’s  Delta region or Alabama’s  “black belt”  have challenges that differ greatly from the “Heartland” or Western States.  Values and cultural differences are also evident.  Still there are many common themes including resourcefulness, independence, individuality, faith themes, and community are often shared across many types of rural areas.   When considering community risk and protective factors, risk and protective factors may look different and problems are heightened when the lens of social inclusion or exclusion becomes a consideration.   Rural communities have a long track record of resilence and self reliance.  What can the nation learn?  How communities learn from their peers in other rural areas?  What are shared challenges?  What are unique issues?  How can individuals, organizations, communities and state/federal policymakers partner to enhance child outcomes in rural areas? 

We hope you join us in this important work!


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