Rural West 2017

The conference’s opening session brings together a selection of experts from different disciplines to take stock of the health of today’s Rural West. Thinking broadly about health — personal, population, environmental and ecosystem health — panelists will share framing comments about the critical issues confronting those residing in the Rural West. In discussing the region’s current landscape, this interactive session will challenge all conference participants to share their best ideas with one another on forging an action plan to deliver a healthier Rural West. The dialogue will be actively encouraged to continue throughout the conference and will be summarized at the conclusion of A Healthier Rural West.

The World Health Organization defines health as “a complete state of physical, mental and social well-being, and not merely the absence of disease.” Using this definition, this panel focuses on the well being of the population residing in the Rural West. This population is spread across vast distances, often has few options for care, and confronts greater obstacles to obtaining information. While health care spending in the US is nearly 1/5 of the gross national product, outcomes are not much better than in much of the developing world. Panelists will discuss the major barriers and opportunities to provide and coordinate better health and better care in the Rural West at a fair cost.

The western frontier often evokes imagery of rugged individuals, confronting challenges with a strong spirit of personal determination. What happens when that stereotype meets reality? Understanding the individuals of the west and how they see themselves can help healthcare providers better tailor their outreach and programs to the rural westerner. This panel explores how demographics impact individual health and health care decisions, specifically discussing issues of patient-centric care, including addiction, chronic disease, and preventive actions (nutrition, fitness, etc.).

Public lands are a brooding, ever-present omen in the West. Their historic origin goes back to Thomas Jefferson and James Madison’s fascination with the recent French development of precisely measuring land by metes and bounds instead of tree stumps and wandering streams. With their creation of the Cadastral Survey they and other subsequent political leaders began to carve out boundary lines, first for states, then counties, cities and towns. Vast areas, particularly in the West, were left unclaimed, and thus became public lands. Now, in the 21st century some states like Nevada, Utah, and Wyoming have half of their landmass owned and managed by the federal government. Throughout the 20th century Sage Brush rebels rallied State's rights advocates to a call of returning federal public lands to the States where they lie. But, after two centuries of Federal public support for these lands is it fair to return them wholesale to the States where they are found?

Many factors contribute to an individual’s state of health. The Centers for Disease Control highlights five key determinants, including one’s biology and genetics, individual behavior, available health services, physical environment, and social environment. This panel explores the links between social disparities and health outcomes in the rural American West. Speakers will focus on identifying the needs of the most vulnerable populations in the rural southwest, including Native American tribes and Latino communities, increasing human capacity to address those needs, and how to improve the communication gap between doctors and patients.

In the environment of the American West, the elements of fire and water play an outsized role. Managing the health of the environment, from the high Rockies to the Mojave and Sonoran deserts, means ensuring there is enough clean water to support flora and fauna and enough control of natural fuels to ensure that fires do not go out of control, as the 2011 Las Conchas fire did in the Jemez mountains. Have state and federal policies to respond to drought and to control fires worked? Have failures to manage water and fire harmed human health? What lessons have been learned and what should be done to manage fire and water going forward?

The stereotype of the influential small-town newspaper is enduring. People may have derided their local paper, but they read it — or rued the fact that they hadn’t. Reporting and editing for these small papers was intimate in a way that big-city journalism could never be. But many of the forces that have disrupted metro and national news organizations have decimated small-town journalism as well. Consolidation and new forms of ownership mean that key decisions about staffing may be made hundreds of miles away, by people who have no stake in the community. The implications for government accountability and effective self-governance are ominous. What new forms of journalism can emerge to counter these trends?