Rhonda Strebel remembers one Friday afternoon, many years ago, when she first visited a farmer at his home. She left that afternoon, offering him her card, saying she’d be there to help if he ever needed someone to listen.
When her phone rang Monday morning, the farmer told her his wife had left with the kids and he had been contemplating suicide.
While that call left an especially indelible mark on Strebel, she notes it’s just one example of the thousands of people who have been helped through the Rural Health Initiative (RHI), a nonprofit service that helps rural families in Shawano, Outagamie and Waupaca counties.
Founded 15 years ago, the RHI was conceived by a ThedaCare Community Health Action Team (CHAT).
“ThedaCare’s ultimate mission is the health of the community,” says Strebel, who heads up the initiative that makes preventive health care visits and offers no-cost screenings to farm families, who may be hesitant to visit clinics or doctors.
“We were looking for a model to address community health concerns in a way that’s really sustainable over time,” says CHAT’s Paula Morgen.
Strebel says CHAT raised the concern: Why don’t farm families come in for care until it’s almost too late? The solution was RHI.
“Why can’t we take health care to the farm?” Strebel says, echoing the group’s initial idea.
While farmers often face barriers to health care — insurance or lack of it, time, transportation — RHI aims to remedy that with free house calls. “We did not want another barrier, another reason farmers did not want the service,” Strebel says.
Strebel, who grew up on a dairy farm in Shawano County, understands the culture of farming and how farmers can be reticent to seek health care. “(RHI) really needed someone who knew health care but had an agricultural background. We all have to understand the culture of farming; (that’s) what builds the trust and really makes us unique.”
Their farm is farmers’ top priority, Strebel says. They are focused on their animals, crops and the work they need to do. Their own personal health is nowhere near the top of the list of concerns, she says.
“They don’t think about themselves or their well-being,” she adds.
Strebel — who has a bachelor’s degree in sports medicine and a master’s degree in health care administration — and two nurses comprise RHI, which has a modest $200,000 budget (funded in large part by ThedaCare and other donors) and serves about 1,300 farms in the three-county area.
“We go as many times as needed — at least once a year to the people who are interested,” Strebel says.
RHI reps offer screenings for blood pressure, cholesterol and glucose — aiming to keep those numbers in line and prevent manageable chronic diseases such as heart disease and diabetes, among others.
Once the farmers know their “numbers,” Strebel says, they are willing to be compliant to address potential health needs. “We are able to detect (health problems) early enough (and intervene)” so it’s less costly down the road.
When Strebel first started, she anticipated pushback and rode to the farms with a milk hauler or vet to earn the trust of the farmers and get a foot in the door. Now, 15 years later, RHI has built trust in the region, having the opportunity to help people who can’t or won’t ask for help.
But while the RHI doesn’t ask farmers to pay for the visits or tests, Strebel admits that the past few years have been tough in the agriculture market, with some funders, like agribusinesses, being impacted negatively.
“We’re in jeopardy. Those who have funded us in the past are financially struggling,” she says. “We may have to start charging for our services.”
Still, the trust and impact the RHI has made is tangible. Over the past few years, it has won several community awards, including the 2006 Wisconsin Top Rural Development Initiative (Wisconsin Rural Partners), 2009 Chancellor’s Wisconsin Idea Award (UW Colleges and UW-Extension), 2012 NOVA Award from the American Hospital Association and 2012 Global Vision Community Partnership from the Wisconsin Hospital Association.
And all those awards start, humbly, around the kitchen table on the farm.
“We do a lot more than take their blood pressure,” Strebel says. “We’ve helped people with mental health issues. We’ve handled domestic abuse. Fifty-two percent of the time, we’re detecting something … that could end up being something costly.”