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Rural Health During the Pandemic: Challenges and Solutions to Accessing Care

Published on: February 24, 2022.


Nearly 1 in 5

Americans reside in rural areas

About this Data Insights

More than 57 million Americans reside in rural areas. Yet this population often experiences poorer overall health and significant barriers to health care, such as distance and transportation, health literacy, privacy and stigma, and provider shortages. In fact, only 12% of physicians practice in rural communities. These barriers to care have been exacerbated by the COVID-19 pandemic, highlighting health disparities in rural communities. This infographic explores the current state of rural health in the US, including the impact of COVID-19, access to care, and interventions to improve rural health.

This infographic was reviewed by Carrie Cochran-McClain, Chief Policy Officer, National Rural Health Association, https://www.ruralhealth.us/

Citations
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Rural Health: The Basics

Rural health definition: US Food and Drug Administration (FDA), Rural Health, June 6, 2021

More than 57 million Americans reside in rural areas: Statista, Size of urban and rural population of the US 1960-2020, January 20, 2021

Nearly 1 in 5 people in the US live in rural areas: US Census Bureau, One in Five Americans Live in Rural Areas, August 9, 2017

97% of the US land mass is rural: US Census Bureau, Defining Rural at the US Census Bureau, December 2016

Compared to urban Americans…: Sally C. Curtin, M.A., and Merianne Rose Spencer, M.P.H., National Center for Health Statistics, Trends in Death Rates in Urban and Rural Areas: United States, 1999-2019, September 2021

Rural areas often face unique characteristics: Centers for Disease Prevention and Control (CDC), About Rural Health, August 2, 2017

COVID-19’s Impact on Rural Communities

Cases:

Over 7.9 million COVID-19 cases were reported between February 2020 and December 2021: Housing Assistance Council, COVID in Rural America in 5 Charts, December 23, 2021

Rural Americans at greater risk: The Chartis Group, Crises Collide: The COVID-19 Pandemic and the Stability of the Rural Health Safety Net, 2021

Vaccination:

Rural vs. Urban Rates: Tim Murphy and Tim Marema, The Daily Yonder, Rural Vaccination Rate Climbs 1.25 Points, Inching Toward 50%, February 2, 2022

Overall Trend: Shannon M. Monnat and Yue Sun, Lerner Center for Public Health Promotion, Center for Aging and Policy Studies, Why are COVID-19 Vaccination Rates Lower in Rural than in Urban areas of the US?. September 24, 2021

Rural communities experience lower vaccination rates: Murthy BP,

Sterrett N, Weller D, et al., Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report: Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties - United States (December 14, 2020–April 10, 2021), May 21, 2021

Toll:

2021 - 2022: weekly number of rural COVID-19 deaths: Tim Marema, The Daily Yonder, For Second Consecutive Week, Rural Counties Break Record for New Infections, January 20, 2022

1 in 434 deaths: Lauren Weber, Kaiser Health News, Covid Is Killing Rural Americans at Twice the Rate of Urbanites, September 30, 2021

Original Study: Fred Ullrich, BA, Keith Mueller, PhD, COVID-19 Cases and Deaths, Metropolitan and Nonmetropolitan Counties Over Time, February 2022

This data is updated weekly, find the current reports here.

1 ICU bed for every 10,000 people in rural America: Kaiser Family Foundation, Interactive Maps Highlight Urban-Rural Differences in Hospital Bed Capacity, April 23, 2020

Rural health safety net: The Chartis Group Chartis Center for Rural Health, The Rural Health Safety Net Under Pressure: Understanding the Potential Impact of COVID-19, April 2020

Access to Care in Rural America

Barriers to healthcare - distance and transportation: Rural Health Information Hub, Transportation to Support Rural Healthcare, April 24, 2020

Barriers to healthcare - privacy and stigma: Rural Health Information Hub, Healthcare Access in Rural Communities, August 18, 2021

Barriers to healthcare – health care workforce shortages:

61% of primary care health professional shortage areas: The Chartis Group, Crises Collide: The COVID-19 Pandemic and the Stability of the Rural Health Safety Net, 2021

Only 12% of physicians practice in rural communities: Rural Health Information Hub, Healthcare Access in Rural Communities, August 18, 2021

Barriers to healthcare - health literacy: Healthy People 2020, Office of Disease Prevention and Health Promotion, December 28, 2021

Barrier to healthcare - health insurance access: Jennifer Cheeseman Day, US Census Bureau, Rates of Uninsured Fall in Rural Counties, Remain Higher Than Urban Counties, April 9, 2019

Hospitals closures and consolidation:

Since 2005, 181 rural hospitals have close across the country: The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Rural Hospital Closures, 2014

Rural hospital closures (2005-2020): The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Rural Hospital Closures, 2014

A majority of closures were in North Carolina, Tennessee, and Texas: Maryville University, Rural Hospital Closures: How COVID-19 Impacted Hospitals, 2022

453 more are vulnerable to closure: The Chartis Group, Crises Collide: The COVID-19 Pandemic and the Stability of the Rural Health Safety Net, 2021

Impact on access:

Rural hospital closures create a gap in services: The Chartis Group, Crises Collide: The COVID-19 Pandemic and the Stability of the Rural Health Safety Net, 2021

Low reimbursement rates due a reliance on Medicare: Jane Wishner, Patricia Solleveld, Robin Rudowitz, Julia Paradise, and Larisa Antonisse, Kaiser Family Foundation, A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies, July 7, 2016

Average distance to care pre- and post- closure: US Government Accountability Office, Rural Hospital Closures: Affected Residents Had Reduced Access to Health Care Services, January 21, 2021

Improving Rural Health:

Rural Provider Safety Net:

Community health centers: Rural Health Information Hub, Community Vitality and Rural Healthcare, May 26, 2021

Rural health clinics: Department of Health and Human Services, HHS Provides $424.7 Million to Rural Health Clinics for COVID-19 Testing and Mitigation in Rural Communities, June 11, 2021

School-based clinics: Angela Fairbanks, Boise State School of Nursing, A helping hand in rural Idaho: Boise State and community partners open a school-based clinic, March 2, 2021

Critical Access Hospitals: Rural Health Information Hub, Critical Access Hospitals (CAHs), September 3, 2021

Interventions to Address Access to Care:

Telehealth

Rural areas often have lower utilization rates: Lok Wong Samson,

Wafa Tarazi, Gina Turrini, Steven Sheingold, Assistant Secretary for Planning and Evaluation, Office of Health Policy, Research Report - Medicare Beneficiaries’ Use of Telehealth in 2020: Trends by Beneficiary Characteristics and Location, December 2021

Broadband and computer access: Jazmyne Sutton, PhD, Bipartisan Policy Center, Telehealth Visit Use Among U.S. Adults, August 2021

Why is telehealth useful?: Katie Palmer, STAT, At a rural ICU, COVID-19’s summer surge put telehealth to the test, October 5, 2021

Workforce Programs: Gina Turrini, D. Keith Branham, Lucy Chen, Ann B. Conmy, Andre R. Chappel, Nance De Lew, and Benjamin D. Sommers, Assistant Secretary for Planning and Evaluation Office of Health Policy, Access to Affordable Care in Rural America: Current Trends and Key Challenges, July 9, 2021

Accessibility: Department of Health and Human Services, A Core Set of RuralRelevant Measures and Measuring and Improving Access to Care: 2018 Recommendations from the MAP Rural Health Workgroup, August 31, 2018


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