Rural Nursing: Concepts, Theory, and Practice

By Helen J. Lee; Charlene A. Winters | Go to book overview

CHAPTER TWENTY-ONE
Environmental Risk
Reduction for Rural
Children

Wade G. Hill and Patricia Butterfield

Rural living is often portrayed as inherently healthy and wholesome, with children enjoying the benefits of fresh air and clean water. The idealized view of rural life is perpetuated by what some have referred to as the “agrarian myth,” in which youngsters thrive on living away from the artificiality and materialism of cities (Kelsey, 1994). However, the realities of rural living and their requisite patterns of environmental exposure are complex, dynamic, and multidimensional. Exposure risks to children vary by place, by time, and by age. The risks also vary by parents’ occupations, seasonal changes, and jurisdictional policies addressing the use and disposal of local toxicants. Each of these factors, plus many more, creates a complicated web of exposures that influence current and future risks of disease. Exposure patterns in children are so multifaceted that it is not unusual to see very different measures of exposure among three or four children living under the same roof. Such are the challenges in understanding environmental health risks to children living in rural communities.

However, the challenges inherent in assessing complex exposures in children are, in many ways, dwarfed by the ability of the current health care system to document patterns of exposure in groups at risk. Neither exposures to biologic and chemical agents nor their potential health consequences (e.g., asthma, neurodegenerative diseases) are recorded systematically in medical databases. Health providers have a superficial

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