Original Article

Student-Led Rural Health Fairs: Attempting to Improve Medical Education and Access to Health Care

Authors: David C. Landy, MPH, Michael A. Gorin, MD, Mark T. O’Connell, MD

Abstract

Objectives: Residents of rural communities, especially in the Southeast, have decreased access to health care. Ensuring medical students receive adequate exposure to their issues is complicated by the urban location of most schools. We describe health fairs conducted in rural communities to suggest how having medical students use screening tools can identify patients with risk factors for disease which can offer students the opportunity to learn about rural health issues through patient counseling.


Methods: The Mitchell Wolfson Sr. Department of Community Service, a University of Miami Miller School of Medicine student-led organization, conducts fairs at four sites throughout the rural Florida Keys. Medical students, under the supervision of attending physicians, offer screening and preventive health services including risk factor screening for cardiovascular disease, ophthalmological exams, dermatologic exams, osteoporosis screening, and female exams with pap smears. These fairs were reviewed.


Results: In the past three years, 1694 unique patients were seen. Many lacked a primary care provider (46%) or health insurance (43%) and were provided screening for several disorders including cardiovascular disease risk factors (hypertension, diabetes, dyslipidemia, and obesity). Screening revealed that many patients (41%) had multiple markers of elevated cardiovascular disease risk. This provided experiences to more than 200 students each year.


Conclusion: Fairs provide medical students exposure to rural health issues through the valuable opportunity of using risk factor screening tools and counseling. This provides valuable information to patients of rural communities. Future research should examine how fairs influence student knowledge and attitudes toward rural health and affect health outcomes.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Rosenthal TC, Fox C. Access to health care for the rural elderly. JAMA 2000;284:2034-2036.
 
2. King DE, Crisp JR. Rural-urban differences in factors associated with poor blood pressure control among outpatients. South Med J 2006;99:1221-1223.
 
3. Chan L, Hart LG, Goodman DC. Geographic access to healthcare for rural Medicare beneficiaries. J Rural Health 2006;22:140-146.
 
4. Blumenthal SJ, Kagen J. The effects of socioeconomic status on health in rural and urban America. JAMA 2002;287:109.
 
5. Hart-Hester S, Thomas C. Access to health care professionals in rural Mississippi. South Med J2003;96:149-154.
 
6. Council on Graduate Medical Education. Physician Distribution and Health Care Challenges in Rural and Inner City Areas: Tenth Report to Congress and the Department of Health and Human Services Secretary. Rockville, MD: Health Resources and Services Administration, US Dept of Health and Human Services; 1998.
 
7. Murray CJ, Kulkarni SC, Michaud C, et al. Eight Americas: investigating mortality disparities across races, counties, and race-counties in the United States. PLoS Med 2006;3:e260.
 
8. County Health Rankings: mobilizing action toward community health. Available at: www.countyhealthrankings.org/. Accessed October 10, 2010.
 
9. Arabi Z. An epidemic that deserves more attention: epidemiology, prevention, and treatment of smokeless tobacco. South Med J 2007;100:890-894.
 
10. Singh GK, Kogan MD, van Dyck PC. Changes in state-specific childhood obesity and overweight prevalence in the United States from 2003 to 2007. Arch Pediatr Adolesc Med 2010;164:598-607.
 
11. Mathews TJ, Sutton PD, Hamilton BE, Ventura SJ. State disparities in teenage birth rates in the United States. NCHS Data Brief 2010;46:1-8.
 
12. DeAngelis CD. Commitment to care for the community. JAMA 2009;301:1929-1930.
 
13. Rabinowtiz HK, Diamond JJ, Markham FW, et al. Medical school programs to increase the rural physician supply: a systematic review and projected impact of widespread replication. Acad Med 2008;83:235-243
 
14. Young L, Rego P, Peterson R. Clinical location and student learning: outcomes from the LCAP program in Queensland, Australia. Teach Learn Med 2008;20:261-266.
 
15. Dalley B, Podawiltz A, Castro R, et al. The Joint Admission Medical Program: a statewide approach to expanding medical education and career opportunities for disadvantaged students. Acad Med2009;84:1373-1382.
 
16. Pathman DE, Taylor DH Jr, Konrad TR, et al. State scholarship, loan forgiveness, and related programs: the unheralded safety net. JAMA 2000;284:2084-2092.
 
17. Wheat JR, Turner TJ, Weatherly L, et al. Agromedicine focus group: cooperative extension agents and medical school instructors plan farm field trips for medical students. South Med J 2003;96:27-31.
 
18. Eley D, Baker P. The value of a rural medicine rotation on encouraging students toward a rural career: clear benefits from the RUSC program. Teach Learn Med 2009;21:220-224.
 
19. Ferguson WJ, Cashman SB, Savageau JA, et al. Family medicine residency characteristics associated with practice in a health professions shortage area. Fam Med 2009;41:405-410.
 
20. Calvo-Romero JM, Lima-Rodríguez EM. Adverse outcomes in patients with venous thromboembolic disease from a rural population. South Med J 2008;101:601-603.
 
21. Handel DA, Hedges JR. For the SAEM IOM Task Force. Improving rural access to emergency physicians. Acad Emerg Med 2007;14:562-565.
 
22. Triller DM, Donnelly J, Rugge J. Travel-related savings through a rural, clinic-based automated drug dispensing system. J Community Health 2005;30:467-476.
 
23. Baldwin LM, Cai Y, Larson EH, et al. Access to cancer services for rural colorectal cancer patients. J Rural Health 2008;24:390-399.
 
24. Axelrod DA, Guidinger MK, Finlayson S, et al. Rates of solid-organ wait-listing, transplantation, and survival among residents of rural and urban areas. JAMA 2008;299:202-207.
 
25. Celaya MO, Rees JR, Gibson JJ, et al. Travel distance and season of diagnosis affect treatment choices for women with early-stage breast cancer in a predominantly rural population (United States).Cancer Causes Control 2006;17:851-856.
 
26. Quin J, Markwell S, Rogers LQ, et al. Home anticoagulation testing: predictors of rural patient interest. J Surg Res 2006;136:232-237.
 
27. Smith RS. Telemedicine and trauma care. South Med J 2001;94:825-829.
 
28. McGrew M, Solan B, Hoff T, et al. Decentralized medical education in rural communities: the circuit rider connection. Fam Med 2008;40:321-325.
 
29. Hart GL, Larson EH, Lishner DM. Rural definitions for health policy and research. Am J Public Health 2005;95:1149-1155.
 
30. Hall SA, Kaufman JS, Ricketts TC. Defining urban and rural areas in U.S. epidemiologic studies. J Urban Health 2006;83:162-175.
 
31. Small Area Health Insurance Estimates (SAHIE) program, US Census Bureau. Available at: http://www.census.gov/did/www/sahie/index.html. Accessed May 7, 2010.
 
32. Center for International Earth Science Information Network (CIESIN), Columbia University; and Centro Internacional de Agricultura Tropical (CIAT). Gridded Population of the World Version 3 (GPWv3): Population Density Grids. Palisades, NY: Socioeconomic Data and Applications Center (SEDAC), Columbia University; 2005. Available at: http://sedac.ciesin.columbia.edu/gpw. Accessed April 10, 2010.
 
33. American Association of Medical Colleges. Member Medical Schools. 2010. Available at: http://services.aamc.org/memberlistings/index.cfm?fuseaction=home.search&search_type=MS&wildcard_criteria=&state_criteria=CNT%3AUSA&image=Search. Accessed April 10, 2010.
 
34. Chen F, Fordyce M, Andes S, et al. Which medical schools produce rural physicians? A 15 year update. Acad Med 2010;85:594-598.
 
35. Rosenblatt RA. Do medical schools have a responsibility to train physicians to meet the needs of the public? The case of persistent rural physician shortages. Acad Med 2010;85:572-574.
 
36. Aponte J, Nickitas DM. Community as client: reaching an underserved urban community and meeting unmet primary health care needs. J Community Health Nurs 2007;24:177-190.
 
37. McCary J, Schainker E, Liu P. A community care initiative: Maryland and Hopkins students take to the streets in Baltimore City. Md Med J 1999;48:26-32.