Addressing Diversity Trends in Rural America

Background:  The new trend in US immigration is an increase in the number of Hispanics, the largest minority population, into rural America.  This growing trend in racial and ethnic diversity found in small and rural America is expected in our future growth.. This demographic change is highlighted by rural farming communities that are defined by migrant labor composed primarily of Hispanics.  Most often this definition is one of supposed “decline in community.”   This presentation proposes one strategy for integrating migrants into these communities in order  to strengthen the community and to save them from putative decline.  We focus on the differential HIV risks and access to HIV care and treatment of newcomers and long-timers.  Migrants who have been in the community for 5 years or more (long-timers) have greater HIV risk behaviors (more risky sexual behavior and greater alcohol use) and have greater access to primary care.  Newcomers (5 years or less) report lower HIV risk behaviors and have less access to primary care.   Methods:  This is an analysis of adapting an evidence-based health intervention utilizing a sociological theory.  This discussion will show how community structures can be strengthened by incorporating the social networks of the growing Hispanic minority into the health care system.    Fundamental Cause Theory predicts that access to health care resources will improve the health of disadvantaged migrant workers through strengthening social support within the networks, thereby reducing HIV sexual risk behaviors and excessive alcohol use.  Results:  Amigos Hacen Cambios, the proposed intervention, will assess migrant social networks for inclusion of newcomers and long-timers  in order to take advantage of their strengths. The heterogeneity of the networks increases the probability of diffusion of the innovation or new ideas.