Remembering to Ask Humpty

  • September 10th, 2002

Collaboration Brings Better Health to America’s Rural Areas

Dr. John Higginbotham directs UA's Institute for Rural Health Research.
Dr. John Higginbotham directs UA’s Institute for Rural Health Research.

Several years ago the trustees of The University of Alabama realized that rural health care needs and solutions were scattered throughout six colleges at UA. To bring together these like-minded people, the Institute of Rural Health Research was begun. The institute, which recently observed its first anniversary, strives to cut red tape and harness the efforts of a wide number of disciplines for one purpose: health in rural America.

The IRHR brings together the College of Community Health Sciences, the College of Nursing, the Culverhouse College of Commerce and Business Administration, the School of Social Work, the College of Human Environmental Sciences and the College of Arts and Sciences.

While there are many people at the University who were interested in improving health from various standpoints, there wasn’t a mechanism in place that allowed coordination of those efforts. Now there is.

“All of our health-related areas have a rural mission,” said Dr. Nancy Barrett, provost and vice president for academic affairs. “So the idea was to set up a research institute that would complement our rural health instructional programs by focusing faculty activities in those programs and also give emphasis to the role of our University in rural health education, both in-state and regionally.”

The IRHR follows the World Health Organization’s definition of health, which says health is not just the absence of disease, but also encompasses physical, mental and social well-being.

“My favorite saying is that Humpty Dumpty rhyme: ‘All the king’s horses and all the king’s men couldn’t put Humpty together again,’ ” said Dr. John Higginbotham, IRHR director. “But nobody asked Humpty. And that’s what universities are often accused of: doing research on communities and not with communities.”

He said communities know more about themselves than someone on the outside — they just need help putting a plan in place to address the issues they already know are there.

“We do that by trying not only to investigate problems of disease and infirmity, but also the physical, mental, social, socioeconomic and educational components,” Higginbotham said.

One example he gives is a project in Marion County, Ala., to improve mental health services for the elderly. They wanted to apply for a federal grant but didn’t know how to go about doing that. So the community is taught how to apply and gather all the information they will need.

Health encompasses many things, Higginbotham quickly points out. “You can’t buy your prescription drugs if you have a hard time paying the light bill, so that’s an economic part of health. If you don’t have a place where you feel safe enough to exercise, that’s another part of health. If you can’t get the right kinds of food you need and you’re a diabetic, that’s another part of health. And if the nearest doctor is 40 miles away and you don’t have a car, that’s another part of health.

“I think we’re going to see increasing federal grant activity coming through that institute as our faculty become better known and more faculty are learning about the institute and are willing to bring their research projects through it,” Barrett said. “We hope to host another Rural Health Conference next spring, and I think that some of the activities coming out of the Institute will help galvanize the interest in rural health issues both in the community and on campus.”

Some of the ongoing research at IRHR relates to prostate cancer, immunization among older Americans and breast and cervical cancer screening. They currently work with the National Cancer Institute, the Centers for Disease Control and Prevention, the American Academy of Family Practice and the Alabama State Health Department.

Health and the Rural Versus Urban Population

  • Rural areas have more elderly (18%) than do urban areas (15%)
  • The poverty rate is higher in rural areas (14%) than in urban areas (11%)
  • More rural residents are uninsured (18%) than urban residents (15%)
  • Medicare spends $913 less on rural beneficiaries than on urban ones
  • 4% fewer urban poor receive Medicaid coverage than urban poor
  • Nearly half of rural Americans live in primary care health professional shortage areas

The University of Alabama, part of The University of Alabama System, is the state’s flagship university. UA shapes a better world through its teaching, research and service. With a global reputation for excellence, UA provides an inclusive, forward-thinking environment and nearly 200 degree programs on a beautiful, student-centered campus. A leader in cutting-edge research, UA advances discovery, creative inquiry and knowledge through more than 30 research centers. As the state’s largest higher education institution, UA drives economic growth in Alabama and beyond.