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marsh 2818743 1920According to the 2010 U.S. Census, more than 59 million people live in rural areas. This accounted for 19.3 percent of the total population. The National Institute of Minority Health and Health Disparities of the National Institutes of Health identified rural versus urban residence as a health disparity in 2016, with health disparity defined as a difference in health that is considered unnecessary. As an example, cancer deaths are higher in rural than urban areas of the United States (180/100,000 vs. 158,000/100,000).[1]

The Improved Care and Provision of Rural Access to Eliminate Health Disparities (ICARED) project was developed by the School of Medicine in 2015. The South Carolina Department of Health and Human Services then allocated $2 million annually to provide clinical services, practice support, innovative technologies and collaborations targeting rural health issues.

ICARED has developed new rural health field placement internships to train MSW students in rural practice during the first year of the College of Social Work participation. This is made possible by a grant from the Health Resources and Services Administration (HRSA).

“We’re able to give 26 social work students a $10,000 scholarship to complete their field education experience in a setting that serves rural and medically underserved populations,” said Dr. Melissa Reitmeier, Director of Field Education. “It’s an additional and enhanced curriculum for our field placement students to work in more than one discipline. I developed modules specific to rural practice that gives our students added knowledge they wouldn’t normally receive in the curriculum. This includes better preparing them to participate in a rural workforce and ethics in rural practice.”      

Medically Underserved Areas of SCIn part because identified rural healthcare needs remain unmet in South Carolina, the College of Social Work, in cooperation with the School of Medicine, Arnold School of Public Health, and Colleges of Nursing and Pharmacy are working together to help combat the problem of a shrinking rural health workforce. The School of Medicine’s Rural Health Initiatives Overview concluded that 23 percent of South Carolina’s population lives in a rural county, and only 10 percent of the state’s doctors have primary practices in those areas.

In addition to field placement internships, Dr. Teri Browne and ICARED Program Coordinator Rebecca Christopher will present, “Rural Matters: Recruiting and Retaining Our Rural Health Workforce.” The free, seven training sessions from November 2017 to May 2018 will be held to reach 17 of South Carolina’s high need rural areas, known as “Disease Hotspots.” The trainings will focus on improving and enhancing retention of health professionals, while providing education, resources and best practices related to interprofessional health services to enhance service deliveries.

“We’ve compiled evidence-based best practices to help practitioners in rural areas throughout the state attract and retain staff,” said Dr. Browne. “This has been a chronic issue in health, mental health, behavioral health and integrated health settings.”

Christopher, who received her MSW from USC, cited specific examples of rural health disparities. Rural healthcare in South Carolina is an issue close to Christopher, who is from Pelion, a small town in Lexington County.

“Only 10 percent of the physician workforce in South Carolina has their practice in rural counties,” said Christopher. “It becomes an issue with health outcomes as 1.2 million South Carolinians live in primary care shortage areas, so that’s the reason behind the project.”

The project team has also developed course modules for social work classes, focusing on rural health practice issues and skills. While the materials are being used for seminar classes this academic year and refined for future use, the course modules will also be submitted to the National Center for Interprofessional Practice and Education, and the Council of Social Work Education to distribute nationally.      

The ICARED project has also allowed the College of Social Work to build networks, and associate, with statewide organizations. One such partnership is with the South Carolina Area Health Education Consortium (AHEC). The organization supports the state’s healthcare workforce by focusing on recruiting, retaining and educating professionals.

“AHEC are experts on training and development and perform research on the best time to present trainings,” said Christopher. “They’re also responsible for most of the continuing education.”

Rural practitioners do not have the same access to professional resources and training as rural areas. Nonetheless, the ICARED project aims to help remove the negative stigma of rural healthcare.

“We need to change the narrative of rural settings to help bring in more professionals and support the providers in these areas,” said Christopher. “This leads to limited supervision opportunities, which only adds to the already limited opportunities. One goal of the project is to build a network.”

The first training will be held on November 20 in Charleston. For more information and to register for a training, visit www.scahec.net/schools.

 To view ICARED's training schedule, click here.

[1] Morbidity and Mortality Weekly, CDC, June 17, 2017

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