ThedaCare: Rural Health Initiative expands preventive services to farms in seven counties

SHAWANO, Wis. – National Rural Health Day, celebrated the third Thursday of every November, is an opportunity to honor the dedication and resiliency of those living in rural America. It’s also a time to recognize rural health care providers and other organizations that support communities. 

On this National Rural Health Day, November 18, 2021, ThedaCare is pleased to announce the ThedaCare Rural Health Initiative (RHI) will have the opportunity to expand the program to reach hundreds of farms across additional counties in Wisconsin with the support of two grants. The two grants, which total nearly $5.5 million directed toward health care and preventive services for farm workers and rural residents, were received after the Wisconsin Office of Rural Health at UW-Madison applied on behalf of the program.

“We are honored to receive these grants to help our teams continue the work that is critical to support the health and well-being of farm families,” said Rhonda Strebel, Manager of the ThedaCare RHI. “The recognition is a testament to the innovate outreach that is being done to address the social determinants of health, and improve the lives of those who call rural Wisconsin home.”

RHI began after a need was recognized in the rural communities. According to Strebel, who has been leading the program since its inception, explained often, farmers only access medical facilities for critical care. In 2003, ThedaCare’s Community Health Action Team model hosted a plunge on the health of farm families, recognizing the stress and limited access to care for those families. 

The solution was to take health care to the farm, meeting people where they live and work. Further discussions determined that several health tests could be done outside clinics and hospitals, and RHI’s “Kitchen Wellness” program was born. Services include: 

  • Health visits at farm families’ homes and businesses
  • Screenings for blood pressure, blood glucose, triglycerides, cholesterol, height, weight and body mass index (BMI) with immediate test results. 
  • Health coaching on a variety of topics, including nutrition, exercise, and more
  • “Workplace Wellness” education, stressing the importance of safety, such as wearing eye and ear protection
  • Language interpreters, if needed, during house calls.

While the number of farms in Wisconsin has dropped from nearly 16,000 in 2004 to 7,000 in 2021, the number of cows has remained the same – meaning farms are much bigger, and making easy access to health care that much more important for farms and farm workers. 

Rural populations face a variety of demographic, economic, social and environmental factors, that can put them at greater risk for common health problems. As most farmers are self-employed, the cost of health insurance can sometimes also create a barrier to affordable health care. Strebel also noted many farmers don’t regularly visit their providers for other reasons. 

“It’s a very unique program,” explained Strebel. “We sit down with people right there in their home, and talk about their health concerns. We check their blood pressure, do blood sugar and cholesterol testing and do a body mass index rating. We also discuss their diet, exercise and general lifestyle.” 

Fifty-two percent of the time, the screenings discover one or more of these issues, catching them before the patient requires a visit to the emergency room, she said. 

The program expanded to Outagamie and Waupaca counties in 2012, and became an official program of ThedaCare as of Jan. 1, 2021, operating under the new name, ThedaCare Rural Health Initiative. It is available to anyone working in agriculture and living in a rural area, as well as other rural residents who may not otherwise have access to health care. This can include family farms, single residents/former farmers, Amish farms, and large-scale farms with a diverse-population of workers. 

CDC Health Equity Grant

As of June 1, 2021, the ThedaCare RHI received a $985,000 Health Equity Grant through the Centers for Disease Control and Prevention (CDC).

The grant, which continues through May 31, 2023, allows the expansion of the ThedaCare RHI from the initial three counties (Shawano, Waupaca and Outagamie) to another four, adding Green Lake, Marquette, Waushara and Winnebago. 

The funding also allows the program to hire six new community health workers to conduct health screenings, provide coaching, prevention and referrals for rural residents. Staff may include those with a nursing or dietary/nutrition background. Additionally, it is highly recommended that new team members have a rural background, understanding health disparities between rural and urban populations, Strebel said.

“Knowing the cultural perspective of farming communities will help our health care workers understand the specific needs of families,” said Strebel. “We hope they consider a famer’s lifestyle, work ethic and responsibilities. All of these aspects play a role in a farmer’s health.”  

In addition to a farmer’s physical health, the RHI also provides a check-in on mental and emotional well-being. 

“We discuss topics that are sometimes difficult to talk about – stress and depression, other things that may be going on with family or finances – factors that can contribute to a person’s mental wellness,” Strebel said. “Our community health care workers will be familiar with resources within the community that can help farm families achieve a better quality of health.” 

The community health workers visit farms within a farmer’s schedule, even if that means showing up at 4:00 a.m.

CDC Vaccination Supplement Grant

The ThedaCare RHI also received a $4.5 million CDC Vaccination Supplement Grant as a part of the American Rescue Plan Act, which started July 1, 2021 and continues through June 2024.

This grant allows an increase of coordinated care services throughout all seven counties covered by the program, expanding health care access and preventive services where it’s needed most, Strebel said. 

“Through this grant, the RHI will have the opportunity to add a physician, a pharmacist, a dietician and a mental health counselor,” said Strebel. “Those caregivers will either come to the home with our team, or visit with families through a virtual option.” 

That helps remove the barrier to virtual health visits as the community health care worker will be there to facilitate. 

“Often technology can be difficult for many people, especially in rural areas where strong broadband internet services might not be as easily accessible,” she said. 

The CDC Vaccination Supplement Grant also includes vaccine assistance, including COVID-19 vaccination education.

“By offering COVID-19 education, our teams can share the facts around the vaccine and the virus, as well as address misinformation,” she said. 

The grant also helps provide other vaccinations, including updating tetanus shots and boosters, which is important in a farm environment. It also offers access to the shingles vaccine for farmers over 50 and pneumococcal vaccines for those over 65.

The RHI program has been supported by ThedaCare and other local health care organizations, as well as local agribusinesses, banks and individuals. Support also comes from the ThedaCare Family of Foundations, which has a designated RHI fund where supporters can continue to contribute to the program. 

For more information about the ThedaCare Rural Health Initiative, please call 715.524.1488 or visit thedacare.org/about-us/community-health/rural-health-initiative/

About ThedaCare

For more than 110 years, ThedaCare® has been committed to improving the health and well-being of the communities it serves in Northeast and Central Wisconsin. The organization delivers care to more than 600,000 residents in 17 counties and employs approximately 7,000 health care professionals. ThedaCare has 180 points of care, including seven hospitals. As an organization committed to being a leader in Population Health, team members are dedicated to empowering people to live their unique best lives. ThedaCare also partners with communities to understand needs, finding solutions together, and encouraging health awareness and action. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a not-for-profit health system with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs, as well as primary care.

For more information, visit thedacare.org or follow ThedaCare on social media. Members of the media should call Cassandra Wallace, Public and Media Relations Consultant at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.