Kitchen Wellness Program continues to improve the health of families
The Rural Health Initiative (RHI) began bringing health care directly to farmers in 2004. Since its inception, it has served 1,380 people in three counties. In 2018, RHI health coordinators met with 356 individuals during 816 visits.
Kay and John Reminger, of Leopolis, have been farming for 40 years. They’ve also been RHI patients for more than 10 years. Kay calls the Rural Health Initiative a lifesaver.
“The best part is RHI comes to our home. It saves us so much time; we don’t have to change clothes and go to town,” said Kay Reminger. “We can sit at our table and talk confidentially. There’s no ‘white coat syndrome’ because we’re relaxed. We can talk about what’s stressing us. Farmers are staunch and self-reliant; they don’t want to appear vulnerable, but at home they can open up more.”
The Initiative was created when it was noted that many times farmers only went to medical facilities for critical care. Healthcare workers observed that if the farmer had come in for a checkup sooner, serious conditions might have been avoided.
“When we were milking cows, John wouldn’t go to a doctor unless he was extremely sick, and I worried about his health,” said Kay. “Now we know what our health conditions are and knowledge is power. We can make lifestyle changes to manage our issues.”
In 2003, ThedaCare put a Community Health Action Team (CHAT) to work. CHAT teams, composed of healthcare providers and community leaders, look for ways to take healthcare outside the walls of hospital and clinics to make communities healthier. This CHAT team immersed itself into the farming community in Shawano County. The proverbial light came on when one farmwoman said, “Unless you come to our farms, you aren’t going to get our husbands in for checkups.”
Further discussions deter-mined that several tests could be done outside clinics and hospitals.
“We immediately recog-nized if we could identify people in this community with blood pressure, cholesterol and blood sugar problems, we could potentially reduce the incidence of people coming in with heart attacks, strokes and diabetic issues,” said Rhonda Strebel, Executive Director for the Rural Health Initiative. From that CHAT group, RHI and the kitchen wellness program were born.
The CHAT team identified two major barriers to farmers seeking health care. First, their cost of self-employed health insurance is high. Strebel said, on average, a farm family pays upwards of $500/month for a health insurance policy that has a $10,000/per person deductible, meaning they only have catastrophic coverage. Routine health care exams are out-of-pocket expenses.
“That discourages farmers from seeking help until the situation is serious,” said Strebel. A second barrier is time. Culturally, farmers work until the work is done, but it’s never done. They won’t stop to take care of themselves. As long as they can keep working, they think they’re fine. It’s when they’re too sick to work that they’ll finally seek medical care.”
Originating first in Shawano County, RHI has served 840 farm families there since 2004. In 2012 the Initiative also began serving Outagamie and Waupaca counties. To date, RHI has visited 570 farms in the three-county area.
Through RHI, outreach health coordinators meet with the farmer and their spouses in their homes. In the case of large dairy operations, they meet with the farmworkers onsite.
“In 2018 we identified 144 serious conditions. Another 106 farmers with chronic conditions weren’t managing them properly, so we worked with them to get their issues under control. Overall, 52 percent of the time we found something serious going on. Some 140 people had high cholesterol numbers, 266 were referred to healthcare providers and six were referred for mental health counseling,” said Strebel.
Nurses check blood pres-sure, do blood testing and measure a body mass index rating. They also go through a health questionnaire and talk with farmers about their diet, exercise and general lifestyle.
“We can call or text them anytime we have concerns about our health,” said Kay.
The non-profit RHI is supported by ThedaCare and other local healthcare organizations. Support also comes from local agribusinesses, banks and individuals. It receives no funding from federal, state or county sources.
Through a grant from the ThedaCare Family of Foundations, the Initiative annually focuses on one specific intervention to improve farmers’ health. In 2019, the focus is “Eat less; feel better,” encouraging farm families to reduce their calorie intake and portion sizes to maintain a healthy weight.
“With the funds we receive from this grant, we’ll increase the number of home visits and contacts we make,” said Strebel. “Typically, we have an initial meeting with a farmer and then check in with them some months later to see if they’re following through on the recommendations we made. This grant will allow us to give more attention to this issue.”
The farmers taking part in the program are receptive. According to Strebel, 94.7 percent of the people they see follow up on the recommendations from health coordinators.
“I think it’s because we take the time to sit at their table and build trust with them. That’s kitchen wellness,” said Strebel.
Anyone engaged in farming is welcome to use the services of the RHI. There are no economic limits. Farmers are invited to contact the RHI by calling 715.524.1488. They can also learn more from the Contact page on Initiative’s website, www.wiruralhealth.org. RHI is also on Facebook at Facebook.com/RuralHealthInitiative.