Challenges of Delivery of Social Services to Rural Areas of the United States
One issue facing Human Services today is the delivery of social services to rural areas of the United States. Families receiving benefits and other social services are a substantial portion of the overall population of people in need of Human Services; for example, as Friedman notes, ???Nearly 20 percent of welfare recipient families reside outside of central cities and metropolitan areas??? (Friedman). Rural families depend on a variety of social services to assist them in moving toward an independent lifestyle. Nevertheless, rural human service delivery faces many barriers including cost, distance, and shortage of professionals. Supplying services to rural areas is difficult, especially when state revenues face the challenge of bringing affordable social services to rural residents.
Delivery of social services in rural areas is very much like those faced in urban areas. Some social service delivery challenges are more distressed in rural areas. For instance, establishing access to proper and affordable child care as well as dependable transportation are extremely challenging in isolated rural areas. Working families in rural areas have to rely on transportation not only to get to work, but also to get to the supports needed to retain their employment. Whether rural residents drive their own cars or use public transportation, they are challenged with longer commutes to their child care providers and workplaces. Since they spend more time traveling to and from work, their children spend more time in child care, resulting in added expenses. Residents dependent on public transportation face even greater challenges. ???Nearly 40 percent of all rural residents live in areas with no public transportation and another 28 percent live in areas with limited levels of service??? (Friedman). Few rural welfare recipients own cars, so having dependable public transportation is crucial. Solutions to this issue include increasing access to transportation by providing assistance so recipients can buy and maintain their own vehicles, using other agency vehicles, van pooling, and encouraging employers to provide transportation.
Another challenge in rural areas is that they usually do not have the foundation needed to attract new businesses. ???Encouraging economic development in these areas is also a challenge. Rural communities often lack the infrastructure needed to attract businesses, and the expenses associated with development can be high; both factors limit job opportunities. Commercial development and lower per capita incomes limit local tax revenue in rural areas which may mean fewer resources for social services??? (Friedman). With state revenues declining agencies are reconsidering their priorities in service stipulations. As state agencies struggle to supply the most thorough support in the best cost effective manner, low income households in rural areas could be left with weakened services. The demographics of rural working families also vary significantly from those of urban households.
These demographics have an effect on these families??™ attitudes toward accessing social services as well as their need for assistance. Friedman notes that ???Compared with their urban counterparts, rural welfare recipients are more likely to be white, living in two parent families, and already working. Rural employment opportunities tend to be more limited and offer fewer benefits. Many rural welfare recipients work more than one job and still live in poverty. Education levels tend to be lower among rural workers, making it more difficult for them to meet minimum job requirements??? (Friedman). Rural residents also handle the problems related with poverty in a different way. For example, in order to get by, numerous rural workers take jobs where they are paid ???off the books,??? income not reported to the government, which is not recognized as meeting the work requirement under the TANF program. Efforts to take part in allowable work activities may disturb their informal work arrangements, eventually causing additional economic difficulties.
In addition, many rural residents are unwilling to admit that they need government assistance because of the stigma attached to receiving services such as Medicaid, TANF, and food stamps, even if they qualify for help. Woodside and McClam observe that ???This negative perception may prevent individuals and families from getting the professional help they need. In some cases, individuals seek informal help from the extended family, the church, and social clubs, particularly when formal support systems are lacking??? (Woodside & McClam). For State agencies to better serve the social service needs of rural working families they should consider options such as using alternative forms of service delivery, such as the web, e-mail, telephone, teleconferencing, out stationing, and home visits. Agencies should increase the use of electronic benefits transfer to help clients overcome the stigma associated with the receipt of public assistance.
Another challenge for residents in rural areas is that they are not given choices of quality reasonably priced health insurance. Rural areas have higher rates of chronic disease, poverty, and have limited access to a primary health care provider. With the current economic decline, there is the possibility for an increase in many of these health and access inequalities that are already an issue in rural areas. Health insurance reform struggles to increase coverage to all Americans and develop the delivery of health care to rural America. High poverty rates and job loss in the current economic recession emphasize the difficulties of accessing health care and rising health care costs in rural areas. ???Fifteen percent of Americans in rural areas live in poverty, compared to 12 percent of people in urban areas, leaving many unable to pay for health insurance. One in five uninsured Americans ??“ 8.5 million people ??“ lives in a rural area. Uninsurance rates are higher for rural minority populations, the rural poor, and those with less than a high school education??? (Chang). Much too frequently the American health insurance system provides limited coverage and leaves rural Americans particularly vulnerable to falling through the cracks.
In the current recession, the rural economy is losing jobs at a quicker rate than the rest of the nation, and the loss of jobs can lead to loss of health coverage. Many rural residents work for small business, seasonally, part-time, or are self-employed, making them less likely to have private, employer sponsored health care benefits. The lack of affordable, comprehensive coverage choices leaves Americans in rural communities without protection from the high costs of health care, which impacts their ability to prosper. Rural Americans pay for nearly half of their health care costs out of their own pocket.
One solution to this issue would be to provide affordable choices to rural residents. Many Americans in rural communities lack employer sponsored coverage. Furthermore, health insurance reform will create a health insurance exchange so families can compare prices and health plans in order to decide which quality affordable option is right for them. The exchange will ensure that there will always be choices of quality, affordable health insurance, regardless if someone moves, changes or loses a job, or becomes sick. Reform will also provide premium assistance to make coverage affordable for rural Americans. Another resolution might be to provide a tax credit for small businesses to purchase health benefits. Rural Americans who work for small business are often unable to obtain insurance. Health insurance reform will provide a sliding scale tax credit to enable rural small businesses to provide health benefits to their employees.
Throughout the history of Human Services it has faced several widespread conflicts. In the present day a major conflict is delivering these services to rural areas of the United States. As compared to that of urban residents, rural families depend on a variety of social services to assist them in moving toward an independent lifestyle. Supplying services to rural areas is difficult, due to the cost, transportation, and varying societal concerns. This struggle will continue to prevail throughout the 21st century if there are no resolutions to these problems.
Friedman, P. (2003, March). meeting the challenge of social service delivery in rural areas. Retrieved from http://www.financeproject.org/Publications/meetingthechallengeIN.htm
Chang, J. (n.d.). More Choices, better coverage: health insurance reform for rural america. Retrieved from http://www.healthreform.gov/reports/ruralamerica/ruralmorechoicesmorecoverage.pdf
Woodside, Marianne, & McClam, Tricia. (2006). An Introduction to human services. Belmont, CA: Thomson Brooks/Cole.