Rural Health Initiative Expands into Outagamie and Waupaca Counties

November 28, 2011

Farmers to Receive House Calls, ‘Kitchen Wellness’ from Nurse

An innovative program designed to improve the health of farmers and their families is expanding into Outagamie and Waupaca counties.

The Rural Health Initiative, Inc., which began serving farmers in Shawano County in 2003, received a $12,000 grant from the Wisconsin Office of Rural Health’s community Rural Hospital Flexibility Grant to expand its services into Outagamie County beginning in February. The Rural Health Initiative is partnering with the Outagamie County Health Department to deliver services in Outagamie County. New London Medical Center is also a partner in the program.

In Waupaca County, the expansion is a partnership between the Rural Health Initiative, ThedaCare and Waupaca Public Health with support from partners in the healthcare and agricultural communities.

As part of the Outagamie program, a nurse visits farmers and their families in their home where she performs basic health risk assessment tests and provides information to improve their health, such as suggestions for a healthier diet or referrals to other medical providers, said Rhonda Strebel, executive director of the Rural Health Initiative.

“The health of our farm families is in crisis. Most farmers either don’t have health insurance or have insurance policies with high deductibles so we are helping them save costs by performing these basic tests and helping prevent problems before they become too serious,” Strebel said.  “By going out to the farmers directly, we are saving them time. Farmers are busy and many of them are committed to their work that they don’t always think about their own health.”

Karen Volkman, a public health nurse with Outagamie County, will begin farm visits in that county during the month of February. She said the program addresses a key issue – improving the health and safety of farmers -- identified by community members. “We’re very excited to be involved in a program like this and taking what they’ve learned in Shawano and applying it here,” she said. “Our farmers are familiar with the program since they’ve heard from people in Shawano about how well it works.”

The public is invited to meetings to learn more about the grant and the offerings through the Rural Health Initiative. They are:

  • Outagamie County: Thurs., Dec. 1, from 2-4 p.m., at the Bordini Center, Fox Valley Technical College, Appleton
  • Waupaca County: Wed., Dec. 14, from 9-11 a.m., at the Waupaca County Courthouse, Room LL42

More than 18 percent of Wisconsin dairy farm families have no health insurance while another 41 percent have only high deductible plans that provide only major medical coverage, Strebel said. Additionally, four of out five farmers do not have health insurance that covers checkups and preventive care. Strebel said rising insurance costs prevent many farm families from seeking help. Without insurance, farmers and their families are more likely to skip medical treatment for minor accidents or chronic conditions, such as high blood pressure or diabetes, Strebel said.

“We like to call our program ‘kitchen wellness’ since it’s a good place to discuss all aspects of health, such as physical, emotional, and financial wellness,” she said. “We bring the care right to them, which helps break down the barriers to healthcare access.”

In Shawano County, Strebel said the Rural Health Initiative serves 325 farm families or about 40 percent of the county’s total farm families. “When we first started out, I remember riding with the milk truckers to meet farmers and introduce them to our program,” she said. “It’s amazing how much we’ve grown.”

Farm families need extra medical attention since farming is ranked as one of the top three most hazardous occupations in the country and they often lack convenient access to health providers, said John Mielke, MD, a member of the Community Health Action Team (CHAT), which helped provide initial support to get the program running in Shawano.

“We’re really excited about the program growing and expanding into Outagamie and Waupaca counties,” said Dr. Mielke, a retired Appleton cardiologist. “The program fulfills a real need for the rural population since male farmers are usually more focused on their own animals and their health, rather than their own.”

Strebel said Shawano County farmers have embraced the program with 96 percent of farmers and their families following through after receiving referrals to other providers. Eighty-five percent of farmers reported being very satisfied with services received through the Rural Health Initiative.

Business, health care and agricultural leaders created the Shawano County Rural Health Initiative in 2003 to bring health care to the farm. Major supporters included Genex Cooperative Inc., Mid-County Cooperative, ThedaCare, AgVentures LLC, Bay Lakes Cooperative, CHAT, Premier Community Bank and Greenstone Farm Credit Services. The Mielke Family Foundation, Shawano Area Foundation, and the Shawano Medical Center Foundation have also contributed.

A key part of the Rural Health Initiative is a health risk assessment that’s designed with farmers in mind and can identify health problems before they become severe, Volkman said. “It’s great we don’t have to start from scratch and we can build off of the success they’ve had in Shawano,” she said.

For more information about the Rural Health Initiative, please visit

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