Abstract
This chapter (a) examines rehabilitation challenges faced by underserved disability populations in rural communities (UDPRC); (b) explores barriers encountered by three large UDPRC (aging adults with disabilities (AAWDs), persons with mobility impairments (PWMIs), and persons with mental health conditions (PWMHCs); and (c) suggests culturally competent practices and social justice advocacy strategies for improved service delivery. Cultural competence and social justice advocacy are emphasized as these lenses may engender equity in rehabilitation practices for UDPRC.
Chapter Highlights
- •
Rural communities reflect small United States (U.S.) population numbers but have higher rates of disabilities.
- •
UDPRC have disproportionate rates of disabilities. These roles are projected to increase considerably.
- •
Resiliency is a common thread between rural cultures and rural populations with disabilities.
- •
UDPRC experience disproportionately limited rehabilitation, mental health, and healthcare service delivery, inaccessible transportation infrastructure, housing insufficiency, limited employment opportunities, inadequate technology access and exposure, poverty, social isolation and stigma, and higher rates of chronic conditions than their urban counterparts
- •
Cultural competence in rural rehabilitation services refers to providers ability to understand and effectively address unique cultural and contextual factors influencing care delivery in rural communities. Culturally competent services affect how UDPRC perceive and access treatment.
- •
UDPRC constitute a culture that providers must understand to offer appropriate, culturally responsive, and comprehensive vocational rehabilitation services.
- •
Providers working with UDPRC must incorporate culturally responsive social justice advocacy practices into service delivery.
Learning Objectives
After reading this chapter, providers will be able to do the following:
- •
Define rural community, rural culture, persons with disabilities, vocational rehabilitation, and rehabilitation counseling.
- •
Define multicultural counseling competence, cultural competence, and social justice advocacy.
- •
Articulate rehabilitation challenges and barriers faced by UDPRC.
- •
Delineate culturally competent initiatives for working with UDPRC.
- •
Delineate social justice advocacy initiatives for working with UDPRC.
Introduction
While the term “rural communities” may conjure up a mosaic of bucolic images, farmlands, and lush landscapes, distinguishing it from “urban communities” presents complex definition challenges (U.S. Department of Agriculture, 2019). Rural and urban are multidimensional concepts, making delineating the lines of demarcation challenging. For this chapter, the definition of rural communities is the U.S. Census Bureau classification. The bureau defines rural as any population, housing, or territory outside of an urban area and urban as urbanized parcels that include 50,000 or more persons (Ratcliffe, 2022). Further, according to the U.S. Bureau of Economic Analysis (2018) and Ratcliffe et al. (2016), rural communities contribute significantly to the U.S. natural resources and economy, are critical for water, food, energy, and recreation, and generate 10% of the country’s gross domestic product.
Urban areas comprise three percent of the U.S. land mass but house over 80% of the population (Ratcliffe et al., 2016). Alternatively, 97% of the US land mass is rural; however, the Centers for Disease Control and Prevention (CDC) reported that 46 million, or 15% of the U.S. population, reside in rural districts (CDC, 2023). The Rural Research and Training Center on Disability in Rural Communities (2017) states that rural Americans represent a smaller percentage of the entire US population but account for a higher percentage of disabilities and activity limitations, with 17.1% compared to 11.7% of urban dwellers. Rates cross gender, race, impairment type, and age, with higher rates for rural veterans and impoverished persons.
Key Terms in this Chapter
Rehabilitation Counseling: A systematic process that assists persons with disabilities in achieving their personal, career, and independent living goals.
Social Advocacy: Efforts aimed at creating an equitable society.
Social Justice: Equal distribution of resources, opportunities, and privileges.
Service Delivery: Access to quality and consistency of clinical care.
Multicultural and Social Justice Counseling Competence: Competencies for integrating culture and social justice into clinical work.
Americans with Disabilities Act: A federal civil rights law that protects the rights of persons with disabilities.
Underserved Populations: Persons from marginalized and disenfranchised groups, specifically AAWDs, PWMIs, and PWMHCs.
Persons with Disabilities: Persons who are physically, cognitively, developmentally, emotionally, and functionally impaired.
Multicultural Counseling Competence: Knowledge, awareness, and skills required to work and interact effectively with culturally and linguistically diverse populations.
Vocational Rehabilitation: Supporting persons with disabilities in finding and maintaining competitive employment in the most integrated settings possible.
Rural Community: People, housing, and territory outside an urban area.
Cultural Competence: Continuous proficiency in applying multicultural counseling competence to service delivery for culturally and linguistically diverse populations.