Rural communities aren’t just built of farms and open spaces. They also house many of the precious natural resources that sustain the economy and represent central contributors in the fight against climate change. What’s more, the increased availability of high-performance Internet infrastructure creates opportunities for development in these areas. There is a great deal of potential within rural communities in the U.S.A., but those possibilities come with unique challenges and demands. Social workers hoping to live and work in rural communities throughout their careers must be prepared to contend with these challenges if they aspire to find success.
A 2016 White House Brief detailing successful rural-community policy measures pointed out that rural communities play a critical role in our nation’s well-being; but they also tend to receive poor access to government services and support due to population density dynamics that limit funding for public services. A similar dynamic exists in the social work sector, as research from the Department of Health and Human Services shows that rural communities tend to have minimal access to social workers in comparison to metropolitan regions. While 17 percent of the U.S. population lives in rural communities, 80 percent of social work graduates work in metropolitan regions. There are approximately 2,157 health professional shortage areas that are classified as rural or frontier regions, the National Association of Social Workers reported.
Given those factors, there is a clear need for social work expertise within rural communities.
Here are five challenges social workers can expect to face in working with members of rural communities:
Cost efficiency challenges
The White House Brief explained that the low population densities in rural regions contribute to a relatively high per capita cost of providing services to the population. To some extent, these barriers can be circumvented by a lower cost of living, but this isn’t universally the case. Instead, social workers hoping to serve in rural communities must be dedicated to their work and capable of serving in a multi-disciplinary role.
The NASW report explained that social workers supporting rural communities often end up in a situation where access to specialized services is severely limited. For example, proximity to mental health treatment centers can be difficult to provide in remote areas. In part because of this lack of access, many rural areas have suicide rates that have increased by 20 percent in the 2004 to 2013 period in rural regions compared to just seven percent in urban areas. Social workers must be prepared to counter these trends through a breadth of training and professional development efforts that provide the wide range of skills needed to help patients across multiple avenues of care.
According to the NASW report, social workers serving in rural areas must be prepared to live in the same areas as their patients. This geographical closeness can mean running into a client at the grocery store or out at a restaurant. Having multiple roles in the community creates unique relationship management challenges, particularly as it makes it more difficult to maintain patient privacy. In fact, a Social Work Today report discussing social work in closed off communities detailed a few common issues that can come up when living in close proximity to patients:
- Determining when it is and isn’t appropriate to develop a friendship with a former client
- Identifying the best way to handle gifts and invitations that may come from clients
- Evaluating if it is a good idea to hire a former client who has a specialized skill you need, such as an electrician
- Assessing the ethical implications that come with a dual role in the community
The NASW report pointed out that the close-knit nature of most rural communities makes it more difficult for patients to maintain their privacy. For example, a rural citizen suffering from a mental illness may feel uncomfortable seeking help because maintaining anonymity is difficult in small communities. In these instances, patients may avoid acknowledging issues or seeking care to prevent neighbors from becoming aware of an issue.
The potential hesitancy to find care combined with decreased access to government services creates an environment where preventative care is extremely challenging, leaving social workers with more crises to deal with, the NASW explained. However, emerging technologies, including electronic health record systems and telehealth capabilities are changing the care dynamics of rural communities, especially as Internet access becomes widespread. Because of this, social workers with the right training can serve as a central hub for care within a rural community and help connect people with the help needed.
To assume that rural communities are inherently poor is problematic. However, poverty does tend to be a more sweeping problem in rural areas, especially as individuals living in remote regions can have extremely limited access to government services and support. Add in the social stigma mentioned above, and identifying poverty, let alone combating it, becomes incredibly difficult. The White House Brief explained that 15 percent of rural counties have reported poverty rates of at least 20 percent in every decennial census going back to 1980. This problem became even more apparent during the economic recession in the 2000s and early 2010s, when unemployment rates in rural areas climbed to 10 percent. During that time, poverty rates hit highs they hadn’t reached in decades, a U.S. Department of Agriculture study found.
The good news is that the USDA has worked hard in the post-recession period to rebuild the economy in rural areas, creating new job opportunities and establishing a framework for sustainable financial health. Rural unemployment dropped to below 6 percent in 2015, funds have been devoted to helping families repair and rebuild homes and more than $12 billion has been invested in community projects, such as schools and hospitals. Another $13.9 billion has been devoted to clean water projects. These efforts to rebuild show the potential for growth in rural communities, but many families will still be recovering in the aftermath of one of the worst economic periods in recent history.
Social workers have an opportunity to serve these families, but to do so they need to be prepared to provide services that counter the effects of poverty and other economic challenges while also having access to fewer government resources. The NASW pointed out that poverty is a particularly complex issue to address, creating a situation in which social workers must be able to help families solve issues such as finding affordable access to childcare, accessing low-income housing, obtaining mental health treatment and identifying educational opportunities.
Access to help
The lack of government services and limited number of specialty care options available in rural communities have been underlying themes in many of these challenges, but the problem of access to care is so acute in rural communities that it deserves special mention. The challenge for individuals in remote areas isn’t just that services aren’t available in close proximity to them; it is that they can’t rely on easy access to transportation to get to locations where care options are available. Sam Hickman, secretary of the caucus and executive director of the NASW West Virginia Chapter, explained that lack of transportation represents a major challenge in most rural communities.
Hickman explained that in most cities, individuals have access to a wide range of transportation options, whereas in rural regions, they may be able to walk, bike or use an automobile, and that’s it. This can significantly limit an individual’s ability to access services and support as they can’t always get to distant locations with ease.
An increased need for veteran care
Veterans of the military often rely on social workers for a variety of care needs as they work to become accustomed to civilian lifestyles, find jobs, take advantage of their VA benefits and access educational opportunities. One major challenge facing veterans, however, is that many of them live in rural areas where access to services is severely limited. The White House Brief explained that a disproportionate number of veterans actively live in or come from rural areas. This highlights the importance of rural areas in the fabric of the nation, but it also emphasizes the importance of providing care and support aimed directly at veterans and their families in rural areas.
Planning for a rural lifestyle
The USDA report on its efforts to revitalize rural communities in the U.S. paints a picture of promise and potential. It highlights job and income growth, improved housing, new opportunities for business growth and a variety of other areas where life is improving in rural communities. Social workers have an opportunity to be a part of this progress as rural regions remain relatively underserved within the profession.
There are many reasons to pursue social work in rural regions. Whether the professional or personal possibilities are exciting to you, the Rutgers University Master of Social Work program offers an opportunity to grow as a professional. Our comprehensive program helps learners gain a breadth of skills as they prepare to grow their careers. Individuals hoping to work in rural communities can use the Rutgers MSW program as a launching point for this change and become part of the solution in complex, close communities that play a critical role in the nation.