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Rural communities like this one face many unique health challenges, but often lack representation in medical research. HHRA hopes to change that.

Archived Blog Posts
  • HHRA Earns Highest Rating from Guidestar/Candid

    By Russell K. King, executive director I’m pleased to announce that the HHRA has earned the Candid Platinum Seal of Transparency for 2023 –an achievement earned by fewer than one percent of US-based nonprofits. The Candid Platinum Seal is the highest level of recognition offered by Candid (formerly known as GuideStar) and is awarded to organizations that meet the highest standards of transparency and accountability. It’s an achievement that’s doubly important for the HHRA. The Candid Platinum Seal demonstrates the HHRA’s commitment to transparency and accountability. Our board, staff, volunteers, and partners believe that by sharing our data, metrics, and strategic priorities with the public, we can build trust and confidence in our organization and our work. To earn the Candid Platinum Seal, non-profit organizations must meet a rigorous set of criteria, including providing complete and accurate information about their mission, programs, finances, and governance on the Candid website, and sharing strategic priorities and information about outcomes. So why is this doubly important for the HHRA?  It’s important for all nonprofit organizations seeking grants and donations because the Candid Platinum Seal is a globally recognized acknowledgement that can inspire a higher level of confidence in the organization among potential grantors and donors–thereby making them far more likely to give. For the HHRA, however, it’s also important because our mission is one that relies on our credibility.  For our work to make a difference in people’s lives, people have to trust our processes, our findings, and our recommendations. The Candid Platinum Seal will help tell the world that, indeed, the HHRA is to be trusted. The leadership of the HHRA has always put integrity of the science first, which sets the HHRA apart in en era awash in willful misinformation and pseudoscience. I’ve long been a fierce advocate for the integrity in science, science reporting, and health information, so I’m proud to carry the torch that’s been passed to me. The HHRA supports researchers willing to seek answers to controversial questions. Our alliance of doctors, researchers, policy experts, and communicators works to answer questions that the government and private sector are too often unable or unwilling to address.  Through it all, we adhere strictly to scientific and ethical best practices to keep our research above reproach. The Candid Platinum Seal is an echo of the values that form the heart of the HHRA.  Let’s wear it with pride as we move forward.

  • Russell King | Executive Director Greetings from the New Executive Director

    By Russell K. King, HHRA Executive Director But yield who will to their separation,My object in living is to uniteMy avocation and my vocationAs my two eyes make one in sight. Robert Frost’s sentiment rang in my ears as I considered adopting the HHRA’s mission as my own. Why, after more than 25 years as a nonprofit CEO, would I take on a challenge of this complexity? Typically, when evaluating a potential professional challenge, you compare the attributes and experiences needed with those you possess. If they align sufficiently, it’s a good omen. I’ve spent more than a decade leading nonprofit organization through transitions, including a foundation that funded scientific research and two associations of medical professionals. I’ve created two development programs and led four others. And I’ve shared my expertise in nonprofit governance and policy, communications, and servant leadership. This constellation of what HHRA needs and what I can offer suggested that this was the direction I should follow. But there was something more. That something echoed Frost’s lines above: The chance to unite that which I enjoy, that which is most meaningful to me, with my work, thus uniting “my avocation and my vocation.” The two principles that have driven both my personal and professional lives have been: 1) we best find our way via the rigors and integrity of the scientific method, and 2) we create the richest meanings for our lives when we strive to help others. The HHRA, using science to improve and protect human health, rings both those bells with vigor. So here I am, eager to help the HHRA build on its illustrious beginnings and move to its next stage of development and growth. I will, of course, need your help. I won’t be shy about asking for it; please don’t be shy about offering it. This mission will require our collaboration, cooperation, and coordination. It will present moments in which we must support, encourage, and inspire each other. Worthy missions always do. For me, it’s the worthiness that matters most. Again, as Frost noted, we do this because it’s the right thing to do: Only where love and need are one,And the work is play for mortal stakes,Is the deed ever really doneFor Heaven and the future’s sakes.

  • A man spraying pesticides California’s Bold Plan to Transform Pest Management Systems is Long on Ambition and Light on Details

    By: Chuck Benbrook, HHRA ED By: Mark Lipson, HHRA Director of Policy and Regulatory Engagement We welcomed the invitation from California’s Department of Pesticide Regulation for members of the public to offer comments and guidance as the State begins to take concrete actions needed to achieve the goals set forth in the new report Sustainable Pest Management: A Roadmap for California. Reviewing the 94-page Roadmap report reminded us how many constituencies, forces, and factors are pushing and pulling farmers, pest managers, and government agencies in multiple directions that are rarely aligned. This Roadmap document describes a very different pest management future that will hopefully become the “de facto” way pests are managed on and off the farm by 2050. If successful by 2050, prevention-based biointensive Integrated Pest Management (bioIPM) will be the norm and there will be minimal if any use of high-risk “Priority Pesticides”. Some thirty-two years ago, DPR hired Chuck Benbrook to carry out a comprehensive evaluation of DPR’s programs and policies to assist in the integration of DPR into the newly-formed Cal-EPA. The resulting report, Challenge and Change: A Progressive Approach to Pesticide Regulation in California, came out in March of 1993. It provides dozens of recommendations intended to do many of the same things that the 2023 Roadmap report hopes to bring within reach. The fact that most pest management systems in California have become more, not less reliant on pesticides over the last 30 years suggests that DPR’s and CDFA’s efforts to achieve Roadmap goals are going to entail heavy lifting, mostly uphill. For this reason in HHRA’s comments, Mark and Chuck describe the nature and substantial scope of changes in laws and policy that will be required to track progress toward Roadmap goals and hopefully, someday, achieve them.

Side Effects of Rural Living: Health Disparities in the Heartland

by Grace Koch | Nov 17th, 2021
by Grace Koch | Nov 17th, 2021
Rural communities like this one face many unique health challenges, but often lack representation in medical research. HHRA hopes to change that.

Thursday November 18th, 2021 is National Rural Health Day. This year the National Organization of State Offices of Rural Health (NOSORH) is specifically highlighting health equity in rural communities. One of the goals of HHRA’s flagship project, The Heartland Study, is to analyze the impact of pesticide exposures on human health, especially on reproductive impacts, healthy pregnancies and children’s development. Our research is already documenting rising levels of herbicide use and exposures across all citizens in the Midwest and rural communities in particular.

Factors impacting the health of rural populations are often underexplored in large scale clinical research projects carried out in large urban centers. According to the U.S. Census Bureau, 97% of land in America is considered rural. Recognition of rural health disparities, and the factors driving them, is an important part of HHRA’s current and future research.

Rural Health Disparity

A whole host of compounding factors have created significant health disparities for rural communities. Rurality is generally classified as any area outside of an urban area. The Census Bureau defines rural as any population, housing, or territory NOT in an urban area. In 2020, there were approximately 57.23 million people living in rural areas in the United States, about 17% of the overall population (Source).

Rural communities are often geographically isolated from the many resources urban and suburban people take for granted. Something as simple as a yearly doctor’s appointment, or finding a healthcare specialist, can be difficult for rural families, due to long distances they may have to travel and limited transportation options. Census data of medical doctors in the US shows that rural areas only have 11 MDs per 10,000 people, compared to 31 per 10,000 in urban/metro areas. In addition, the extent and quality of healthcare services varies greatly across rural regions of the country.

Source: March of Dimes

Data from March of Dimes shows how access to hospitals in the Heartland state of Iowa are limited to only a few counties (see map). Many families in rural counties have little or no access to a nearby hospital or birth center. This distance can complicate a person’s ability to get appropriate treatment for serious health problems, especially for rural individuals who don’t have a car, money, or access to transportation.

Lack of access to healthcare resources has a direct impact on the health and quality of life of rural communities. These populations have statistically higher rates of disease and disability, pain, increased mortality, and shorter life expectancies. The top five leading causes of death (heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke) are all higher in rural populations compared to urban populations.

In the Heartland State of Indiana, for example, cancer related deaths are far higher in rural/nonmetro counties than in urban/metro counties (see chart below).

Source: RHIhub

Food insecurity is also higher among rural populations. According to the USDA Economic Research Service report in 2020, 11.6% of rural households are food insecure, compared to 10.5% for the nation as a whole. Child poverty and food insecurity is also higher in rural areas, with 16.1% of rural households with children being food insecure, compared to 14.8% overall.

Inequality and Social Determinants of Health in Rural Populations

One rural population that is particularly vulnerable to pesticide exposure is farmworkers. HHRA hopes to translate Heartland Study materials into Spanish and other languages to promote participation by farmworker communities.

Health inequalities are often exacerbated by social determinants of health. Rural Americans are more likely to be low in socioeconomic status or be unemployed, have less post-secondary education, and are less likely to have healthcare coverage by employers or through Medicaid.  In addition, rural households have less access to community social programs, foodbanks, and SNAP program benefits.

Social inequities and health disparities go hand in hand. Social determinants of health like income, education, health literacy, environmental health, gender identity, and race/ethnicity all impact an individual’s physical and mental health.

The data backs this up – adults of racial and ethnic populations, living in rural areas, face more health disparities than white adults. A 2017 CDC report showed that Indigenous, Hispanic, and Black individuals in rural areas were more likely to have higher rates of poor health, report multiple chronic conditions, and are at most risk for obesity.

Rural communities may also face more environmental challenges that can impact health. Overall access to safe drinking water, healthy food options, and stable housing is a problem for many rural communities. Hazardous materials often end up in rural areas, contaminating local environments. In farming areas, heavy use of agricultural chemicals can expose both farmers and non-farmers to toxic pesticides in air, water and dust and soil particles. These additional routes of exposure to possibly toxic chemicals are at the crux of HHRA’s scientific research on the impacts of pesticide exposure on reproductive health, pregnancy outcomes and children’s development in the Midwest. By including rurality in our research, we hope to better understand the connections between farming practices, pesticides and other toxins unique to rural areas and public health outcomes.

HHRA is committed to taking account of the impacts of the unique risk factors and unequal access to healthcare services in specific rural areas, as well as gleaning insights from rural-based clinical research. Progress in understanding these factors will help HHRA address how access to food and farming systems impact public health outcomes in the Heartland and beyond. 

We are committed to enrolling at least 30% of participants in our flagship project, The Heartland Study, from rural areas. Most clinical research on pregnancy and reproduction takes place in urban research hospitals, and the unique health challenges faced by rural women are often not explored. We want to change that.

This is why HHRA is working to build research capacity in rural hospitals and why we will be recruiting more rural hospitals into The Heartland Study. 

We are also hoping to raise adequate funding for 2022 to translate our clinical research documents into other languages. Inclusivity starts with ensuring everyone has a seat at the table, where their voice can be heard.

This #GivingNovember please help us expand our reach to rural families and healthcare providers in the Heartland.  You can do so my making a contribution, signing up for the HHRA newsletter and following us on social media.

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