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ThedaCare Rural Health Initiative
March 25, 2021

ThedaCare Welcomes Rural Health Initiative

Offering Convenient Care to Improve the Health and Wellbeing of Rural Community Members

SHAWANO, Wis. – As a not-for-profit health system committed to being a leader in Population Health, ThedaCare is dedicated to empowering people to live their best lives through easy access to individualized care, while supporting each person’s own health and wellbeing.

Leaders are pleased to announce that the Rural Health Initiative (RHI) has become a program of ThedaCare effective January 1, 2021, and now operates under the name ThedaCare Rural Health Initiative.

“For more than 16 years, the RHI has provided safe, convenient access to care through in-home/on-site preventive health screenings, health and safety coaching and referral information for our hardworking, dedicated farm families in Outagamie, Shawano and Waupaca counties,” said Dr. Mark Cockley, ThedaCare Chief Clinical Officer. “The transition to a ThedaCare program is a natural complement to advance our work to predict, prevent and serve as a partner to improve the health and wellbeing of all in Northeast and Central Wisconsin.”

RHI began after a need was recognized in the rural communities. According to Rhonda Strebel, Manager of the ThedaCare Rural Health Initiative, who has also 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.

“RHI’s outreach health coordinators meet with farmers and their spouses at their homes,” said Strebel. “In the case of large dairy operations, we meet with the farm workers at their workplace. 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.”

Under the ThedaCare Rural Health Initiative, the RHI Outreach Health Coordinators will continue to offer the same free, convenient and confidential services farm families rely on, including:

  • 20 minute 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 will continue to be available, if needed, during house calls.

The Need for Rural Health Care

According to 2020 data from the Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP), Wisconsin agriculture is a $104.8 billion industry. In recent years, changes have been significant, including the number of farms and how the work is done.

In 2004, there were nearly 16,000 farms in Wisconsin. In 2021, that number dropped to nearly 7,000. Strebel explained the number of farms may be down, but Wisconsin still has the same number of cows, meaning farms are much bigger, and the amount of work has not changed.

“The face of agriculture is changing,” she said. “Low milk prices, retirements, higher production costs and tariff issues are causing many farmers to exit farming. For families who continue to farm, it’s important that we understand their needs and the unique health challenges they may face.”

Strebel points to 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. “Several demographic, environmental, economic and social factors might put rural community members at higher risk of the top five public health conditions – heart disease, cancer, unintentional injury, respiratory disease and strokes.”

Strebel said this all ties back to the need for RHI’s basic principles of bringing care to the farm.

In 2020, the program served 350 people. Out of 311 health screenings, caregivers detected 36% of people with acute or chronic conditions that needed attention.

“We referred 133 people to health care providers, and helped 60% of them find those providers,” she said. “And we’re looking at more than physical health. Other referrals made in 2020 were related to prescription drug costs, financial and social services and community resources.”

Family Help

“I’ve often heard my husband say he doesn’t have time to go to the doctor, and that’s actually a belief that is common among so many farm families,” said Amy Zernicke, whose husband is a farmer in Shawano County, Wisconsin. “My hope is that they understand their health is important, and they need to make it a priority.”

Zernicke and her husband, Derick, manage a large dairy farm, with hundreds of cows and stock, as well as harvest land. They also have five children. The farm has been in the family for multiple generations. Like so many, they’ve felt the impact of changes to agriculture in Wisconsin.

“The farms are larger now, these are different farms than in previous generations,” she said. “There is more to do with less help, and that can create a lot of stress on farmers.”

Stress – it’s what prompted Amy to reach out to the RHI program, but not for herself, for her husband.

“It started a few years ago,” she explained. “I noticed when the weather began to get colder, Derick’s mood would change. He became depressed, withdrawn, and that wasn’t like him.”

Amy called the RHI to learn more about resources that were available. They talked with caregivers about ways to help Derick through the winter months, and manage his mental health.

“There is so much stigma around asking for help when it comes to mental health,” explained Amy. “I think it’s even more prevalent with farmers. There is this notion that nothing should bother them, they shouldn’t ask for help and it might be considered a sign of weakness. They also feel like there isn’t time to go to the doctor, which is why a program like RHI was so helpful – there was the option to bring care here. There really wasn’t an excuse for not seeking help.”

The Zernicke family has been vocal about their use of RHI and resources. Amy said it can still be difficult for her husband to share his experience, but it’s important to help others know it is okay to say, “I’m not okay”.

“We are grateful for the program, and it is truly a blessing in our rural communities,” she said. “It seems very progressive for health care in Wisconsin. Can you imagine if other rural communities would offer something like this? We could address not only the physical health of farm families, but emotional and mental health as well. We know that when our mental health is strong, we make better decisions. Farms overall would likely be more successful if we made health a priority.” 

Generous Donations Make the Program Possible

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. We appreciate the support of our generous community donors who ensure services will remain available at no-cost to our patients.

“The ThedaCare Rural Health Initiative will remain committed to breaking down barriers and serving as a bridge, not only to improve and sustain the health and safety of farm families, but to also be an advocate for them,” said Dr. Cockley. “We are proud to serve these families, and be a proactive partner in their journey to good health in mind, body and spirit.”

For more information about the ThedaCare Rural Health Initiative, please call 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 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 best lives through easy access to individualized care, supporting each person’s own health and wellbeing. ThedaCare also partners with communities to understand unique 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.