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November 20, 2019


Rural Health Initiative Provides Visits and Education to Rural Residents

November 20, 2019


Rural Health Initiative Provides Visits and Education to Rural Residents

SHAWANO, Wis. – November 21, 2019, is recognized as National Rural Health Day, celebrating the value of rural hospitals and caregivers. Throughout the week, ThedaCare will be highlighting the accomplishments and stories from our rural areas, providing access to care for those living in Northeast and Central Wisconsin.

For more than 15 years, the Rural Health Initiative has provided health services directly to farmers in Shawano County. RHI has served more than 840 farm families there since 2004.

“In 2012, we also began serving farmers in Outagamie and Waupaca counties,” explained Rhonda Strebel, Executive Director of the Rural Health Initiative. “In 2020, the RHI aims to extend those home healthcare services to more rural residents in those counties, working in conjunction with ThedaCare, which will provide significant additional funding to the Initiative.”

The Rural Health Initiative started after it was noted the only time many farmers come to medical facilities is 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 result of the plunge was the belief that farmers are not going to come in for care. Many factors play into that, including farmer’s independent nature and responsibilities on the farm. The solution was to take healthcare 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.

“RHI’s outreach health coordinators meet with farmers and their spouses at their homes. In the case of large dairy operations, we meet with the farm workers at their workplace. We also regularly meet with Amish families in the area,” said Strebel. “We sit down with all these folks 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 go through a health questionnaire and talk with them about their diet, exercise and general lifestyle. When necessary, we refer them to local providers and other resources for follow up care.”

Strebel noted the requests for farm visits have changed in past year, which she attributes to the shift in Wisconsin’s agriculture industry.

“Last year we visited about 700 farmers in the three counties,” she explained. “This year our numbers are down. The face of agriculture is changing. Low milk prices, retirements, higher production costs and tariff issues are causing many farmers to exit farming, causing our numbers to decline.”

According to data from the Wisconsin Department of Agriculture, Trade and Consumer Protection Wisconsin lost 638 dairy farms in 2018. That's a 7.25% decline in the number of registered dairy herds.

Strebel explained when it comes to rural areas, it’s important to know who is being seen for care and where they are being seen.

“We are seeing patients who are coming to local emergency departments (EDs), six or more times per year,” she said. “In essence, they are using the ED like a primary care provider. When people with non-emergency health issues come to the ED, it impacts the cost and quality of care people receive. There are many opportunities to improve care, for the patient and providers.”

In addition, leaders with the RHI have taken into account work from the ThedaCare Community Health Improvement team, which has become more aware of the health disparities between rural and urban populations.

“Statistics show that people who live in cities seem to have a better health status,” Strebel said. “Maybe it’s because they work at a place that has a wellness program, maybe it’s because they have easier access to care, more opportunities for physical activity (workout facilities, parks, YMCAs) and better food options. Rural areas surprisingly do have ‘food deserts’ where obtaining fresh fruits and vegetables isn’t easy or budget friendly. Whatever the reason, the disparities are real.”

According to the Centers for Disease Control, some 46 million Americans currently live in rural areas.

“Several demographic, environmental, economic and social factors might put rural residents at higher risk of death from the top five public health conditions – heart disease, cancer, unintentional injury, respiratory disease and strokes,” said Strebel. “Residents of rural areas tend to be older and sicker than their urban counterparts. They have higher rates of cigarette smoking, high blood pressure and obesity. They also have higher rates of poverty and are less likely to have health insurance.”

ThedaCare and RHI continue to work together to help solve those issues.

“For the group visiting EDs rather than a primary care provider, ThedaCare will identify those folks and our RHI team will reach out to help them manage their health issues better,” Strebel explained. “Maybe their diabetes or asthma is not being controlled well because they can’t afford their medicine or perhaps they aren’t eating properly. Through home visits, education and/or connecting them to primary care providers, we hope to help these people have better health.”

Strebel said the program is looking forward to 2020, and the goal to extend RHI services.

“Our new mission statement is ‘A bridge to improve and sustain the health and safety of rural families’,” Strebel said. “We will continue to serve our farmers as we have for the past 15 years, and we hope to embrace more rural residents as well. It all starts with our basic health screening. From there we’ll continue with education, health coaching and referrals if needed.”

Strebel noted partnerships are imperative to the success of the RHI.

“We are extremely grateful to ThedaCare for the additional support it is providing to RHI to extend our reach,” she said. “We can spend more time improving population health. ThedaCare believes greatly in what we’re doing, and with its support we can improve the lives of people in rural communities. That makes Rural Health Day even more special to celebrate.”

Rural residents in Outagamie, Shawano and Waupaca counties are invited to learn more about the Rural Health Initiative. Contact RHI by calling 715.524.1488, or visit

About ThedaCare

For more than 110 years, ThedaCare® has been committed to improving the health of the communities it serves in Northeast and Central Wisconsin. The organization delivers care to a community of more than 600,000 residents in 14 counties and employs more than 7,000 healthcare professionals. ThedaCare has 180 locations including seven hospitals located in Appleton, Neenah, Berlin, New London, Shawano, Waupaca and Wild Rose. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving our specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a not-for-profit healthcare organization with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs as well as a foundation dedicated to community service.

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Media should call Cassandra Wallace, Public Relations Specialist at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.