Table of Contents
Overview
Definition of Rural Health
Rural health refers to the health status and healthcare access of individuals living in rural areas, which are characterized by low population density and geographic isolation. Access to healthcare services is critical for maintaining good health, yet rural residents often face significant barriers that impede their ability to obtain necessary care. These barriers include financial constraints, such as the need for health insurance that is accepted by local providers, and logistical challenges, such as transportation difficulties to distant healthcare facilities.[5.1] Moreover, rural populations tend to experience a range of adverse social determinants of health, including lower socioeconomic status, limited educational opportunities, and inadequate social support networks, which collectively contribute to poorer health outcomes compared to their urban counterparts.[12.1] The urban-rural divide is evident, as rural residents generally exhibit higher rates of illness and poorer health behaviors.[12.1] Additionally, healthcare access in rural areas is further complicated by provider shortages, which are often exacerbated by the prevalence of negative social determinants, leading to increased risks such as maternal mortality.[13.1] Effective engagement with rural communities is essential for identifying their unique health needs and available resources, which can facilitate the development of tailored health programs and educational opportunities.[18.1] Strategic collaborations among local organizations can also enhance healthcare delivery and improve patient outcomes by pooling resources and expertise.[19.1]Importance of Access to Healthcare in Rural Areas
Access to healthcare in rural areas is of paramount importance, as rural hospitals serve as a critical component of the nation's healthcare delivery system. For nearly one-in-five Americans, these facilities provide essential services and a compassionate lifeline for individuals and families who would otherwise have limited healthcare options.[1.1] Rural healthcare professionals play a vital role in this landscape, often engaging in preventative care programs that include community health screenings, education campaigns, and outreach efforts to ensure that patients have the necessary resources to maintain their health.[2.1] Building strong local networks is essential for reducing patient out-migration, improving care, and supporting community sustainability.[3.1] However, public health in rural areas faces significant challenges, including underfunding and persistent urban-rural disparities. Life expectancy at birth can differ by as much as 1 to 2 years between wealthier urban and rural counties, and disparities can reach up to 5 years between affluent and impoverished counties.[4.1] To address these challenges, initiatives such as the National Rural Health Association's Rural Community Health Initiative aim to promote innovative programs that extend healthcare beyond traditional hospital settings while ensuring the sustainability of community hospitals.[6.1] These programs are designed to increase access to care in rural communities and tackle their unique healthcare challenges.[6.1] Despite these efforts, implementing preventative care programs in rural areas is fraught with difficulties. Challenges include establishing and maintaining public health infrastructure, which is often lacking in rural settings.[8.1] Additionally, rural areas frequently experience shortages of mental health facilities and suicide prevention services compared to urban regions, further complicating access to comprehensive healthcare.[9.1] Policy changes and innovative solutions are crucial for improving healthcare access in rural areas. Strategies such as Medicaid expansion and telemedicine integration have shown promise in addressing longstanding disparities.[14.1] Recent telehealth policy adaptations during the COVID-19 pandemic have also facilitated greater access to behavioral health services, demonstrating the potential for technology to bridge gaps in healthcare delivery.[15.1] Furthermore, the integration of artificial intelligence and mobile health technologies may enhance access to primary healthcare in underserved rural settings, addressing systemic challenges such as infrastructure inadequacies and shortages of trained professionals.[25.1]In this section:
Rural HealthHealth InsuranceSocial Determinants Of HealthSocioeconomic StatusHealth Outcomes
History
Development of Rural Health Initiatives
The development of rural health initiatives has been shaped by various historical efforts aimed at addressing the unique health challenges faced by rural populations. In the mid-20th century, the American Medical Association (AMA) established the Council on Rural Health (CRH) in 1945, recognizing the pressing need for improved healthcare access in rural areas. This initiative was driven by advocates like Sewell, who engaged the medical profession to enhance healthcare delivery through annual conferences and community health councils, which served as platforms for disseminating medical guidance to rural communities.[35.1] Despite these efforts, public health in rural America has remained complex and underfunded, with persistent disparities in health outcomes compared to urban areas. Research indicates that life expectancy can differ significantly between wealthier urban and rural counties, highlighting ongoing inequalities that have been a focus for policymakers.[36.1] Additionally, demographic shifts, such as the outmigration of younger individuals, have contributed to the aging of rural populations, further complicating health service delivery.[37.1] In recent years, the evolution of rural medicine has been marked by the adoption of innovative healthcare solutions aimed at bridging access gaps. Telemedicine and community health programs have emerged as vital tools in this transformation, enabling healthcare providers to reach underserved populations more effectively.[38.1] Furthermore, significant federal policies, such as the Older Americans Act and the Affordable Care Act, have been instrumental in shaping rural health access, emphasizing the need for targeted research and funding to address the unique challenges faced by rural communities.[41.1] Community engagement has also proven essential in the success of rural health initiatives. For instance, the Kentucky Homeplace program exemplifies how local health worker initiatives can effectively address health disparities by providing tailored health coaching and resources to residents in rural Appalachian Kentucky, who face high rates of chronic diseases.[45.1] Such place-based approaches underscore the importance of building trust and rapport within rural communities to enhance health outcomes.[46.1]Role of the American Medical Association
The American Medical Association (AMA) has played a pivotal role in shaping rural health policy, particularly through the establishment of the Council on Rural Health (CRH) in 1945. This initiative was a response to the pressing need for improved healthcare access in rural areas, as recognized by Sewell, the director of the Associated Women of the American Farm Bureau Federation, who engaged the medical profession to address these challenges. The CRH aimed to channel medical guidance to rural communities through annual conferences and the formation of community health councils, thereby facilitating discussions on rural health needs and strategies for improvement.[57.1] In recent years, the AMA has continued to advocate for rural health, particularly in light of alarming statistics indicating that rural residents often experience poorer health outcomes compared to their urban counterparts. A report from the Centers for Disease Control and Prevention (CDC) highlighted that rural populations tend to live sicker and die younger, prompting the AMA to propose five key strategies to enhance healthcare access in these areas. These strategies emphasize the importance of supporting physician private practices, which serve as the backbone of rural healthcare for approximately 46 million patients. However, these practices face significant challenges, including administrative burdens and declining reimbursement rates from Medicare and commercial insurers, which threaten their sustainability.[58.1] Moreover, disparities in access to healthcare services persist, particularly for vulnerable populations such as children with autism. Caregivers have reported that access issues are exacerbated by the unavailability of necessary services in rural areas, highlighting the ongoing challenges faced by rural residents in obtaining adequate healthcare.[59.1] Historical legislative efforts, such as the Kerr-Mills Act, which provided federal funds to support state medical care programs for the poor and elderly, laid the groundwork for future healthcare initiatives, including Medicaid. These historical shifts underscore the importance of continued advocacy and policy development to address the evolving healthcare needs of rural communities.[60.1]In this section:
Challenges In Rural Health
Barriers to Healthcare Access
Rural communities face significant barriers to healthcare access, primarily due to a shortage of healthcare providers. The ratio of physicians in rural areas is notably lower, with only 68 physicians per 100,000 people compared to 80 in urban settings.[89.1] This scarcity is exacerbated by the closure of rural hospitals, which can leave communities without essential healthcare services, creating "healthcare deserts".[89.1] To address these challenges, various innovative strategies have been proposed and implemented. Community health programs (CHPs) and community-directed healthcare interventions have been identified as effective methods for providing essential health services close to home, thereby increasing access and coverage.[87.1] Additionally, funding schemes such as community-based health insurance (CBHI) have been shown to enhance access to healthcare services in low-income rural communities.[87.1] Telehealth has emerged as a critical solution, particularly in the wake of hospital closures, as it allows for the delivery of healthcare services across geographical barriers.[89.1] Programs like Project ECHO (Extension for Community Healthcare Outcomes) utilize tele-mentoring to expand access to specialty care in rural areas, demonstrating the potential of telemedicine to improve patient care.[86.1] Moreover, stakeholder engagement is vital in developing targeted strategies that address the unique needs of rural populations. By leveraging local resources and fostering collaboration among community members, healthcare providers, and policymakers, rural communities can design and implement effective healthcare solutions.[89.1] Other strategies include outreach services, mobile clinics, and the involvement of non-profit organizations, all of which contribute to improving access to primary healthcare services.[87.1]Health Disparities in Rural Populations
Rural populations in the United States face significant health disparities compared to their urban counterparts, largely due to a combination of geographic, economic, and systemic factors. Over 65 million individuals reside in rural areas, where they often experience poorer health outcomes and higher rates of chronic diseases, compounded by limited access to healthcare services.[77.1] The challenges faced by these communities are not uniform; they vary based on geographic characteristics and the specific socio-economic conditions of each area.[77.1] Access to healthcare is critical for maintaining overall health, yet rural residents encounter numerous barriers that hinder their ability to obtain necessary care. These barriers include financial constraints, such as the lack of health insurance or inadequate coverage, as well as logistical issues like transportation difficulties and the need for time off work to attend medical appointments.[76.1] Additionally, many rural residents may lack confidence in their ability to communicate effectively with healthcare providers, particularly if they have limited health literacy or are not fluent in English.[76.1] Trust in the healthcare system is also a significant concern, as individuals may fear that seeking care could compromise their privacy or result in subpar treatment.[76.1] The historical context of rural health disparities has shaped current public health policies, which often fail to adequately address the unique needs of these populations. Systemic socio-economic factors and historical policies have contributed to the perception that rural areas lack economic and social value, further exacerbating healthcare access issues.[80.1] For instance, the unintended consequences of major legislative changes, such as the Affordable Care Act, have disproportionately affected rural communities, highlighting the need for policies that consider the specific challenges faced by these populations.[83.1] Efforts to improve healthcare access in rural areas have included policy changes aimed at supporting healthcare providers, such as tax credits for practitioners working in these regions.[78.1] However, the administrative burdens placed on rural healthcare practices, including prior authorization requirements and declining reimbursement rates, continue to threaten their viability.[79.1] Addressing these disparities requires a multifaceted approach that includes not only policy reform but also targeted funding and resources to enhance healthcare infrastructure in rural communities.[84.1]Recent Advancements
Technological Innovations in Rural Healthcare
Technological innovations are revolutionizing rural healthcare by addressing critical challenges such as limited access to specialists and inadequate healthcare infrastructure. Telemedicine stands out as a transformative tool, enhancing geographical accessibility and reducing health disparities for rural populations by providing essential medical services remotely, thus overcoming transportation barriers and improving health outcomes for vulnerable groups.[118.1] Rural hospitals are increasingly adopting telehealth technologies for critical care services like telecardiology, telestroke, and telebehavioral health, ensuring timely interventions for conditions that require immediate attention.[119.1] The integration of artificial intelligence (AI) into rural healthcare systems further amplifies these advancements. AI technologies enable remote diagnostics, personalized treatment plans, and proactive care management, effectively overcoming geographical barriers and enhancing patient outcomes.[121.1] By efficiently analyzing medical data, AI facilitates early disease detection and reduces the need for in-person consultations, which is particularly advantageous in areas with a shortage of healthcare providers.[120.1] Additionally, AI-driven tools support healthcare providers in making accurate and timely decisions by analyzing electronic health records and real-time patient monitoring data.[122.1] Complementing telemedicine and AI, mobile health clinics and community health workers (CHWs) are crucial in extending healthcare services to underserved communities. Mobile health clinics bring healthcare directly to these areas, while CHWs enhance health outcomes and access to care where healthcare professionals are scarce.[112.1] The synergy of these technologies and community-focused solutions is anticipated to make rural healthcare more accessible, affordable, and patient-centered by 2025.[113.1]In this section:
Community Engagement
Role of Local Organizations and Advocacy Groups
Local organizations and advocacy groups play a crucial role in promoting community engagement in rural health. These entities are instrumental in addressing health disparities and fostering sustainable development within rural communities. Community engagement is recognized as the foundation of effective rural health initiatives, ensuring that development efforts are inclusive, equitable, and long-lasting by involving local populations and respecting their knowledge.[146.1] The active participation of local stakeholders, including community leaders and organizations, is essential for shaping health policies that resonate with the needs of rural populations. By amplifying the concerns and successful strategies of rural hospital stakeholders, these groups can contribute to solutions that address the health crisis affecting rural communities and advance health equity.[154.1] Furthermore, local health care services significantly impact the economy; for instance, a rural primary care physician can generate substantial economic benefits, including job creation and increased local revenue.[155.1] Community engagement strategies that build trust and connection are vital for effective healthcare delivery in rural areas. Establishing rapport between healthcare providers and the community enhances patient satisfaction and adherence to treatment plans.[162.1] Effective strategies for building trust include integrating caregivers into the community through participation in local events and leadership boards, which fosters strong relationships essential for healthcare delivery.[164.1] Moreover, co-created public health actions, which involve community participation throughout the decision-making process, have been shown to reduce health inequities and promote social change.[156.1] Local organizations can facilitate this engagement by partnering with government entities to support community health initiatives, thereby expanding services that effectively engage residents.[165.1]Importance of Community Health Councils
Community Health Councils (CHCs) play a pivotal role in enhancing health outcomes in rural areas by fostering community engagement and addressing local health needs. These councils are instrumental in developing relationships among stakeholders, which enables collaborative efforts to tackle health-related issues and promote overall well-being, ultimately leading to positive health impacts and outcomes.[147.1] The effectiveness of health promotion and disease prevention programs in rural settings heavily relies on community involvement. During the planning and implementation phases, it is essential for rural communities to assess their readiness and perceptions regarding health initiatives, as these factors can vary significantly based on the target population and specific health issues being addressed.[148.1] Identifying community needs and assets is a foundational step in developing effective health programs. Conducting community health needs assessments allows rural programs to pinpoint where to allocate limited resources effectively to meet health-related needs.[149.1] This process not only highlights the physical and mental health requirements of the community but also strengthens partnerships and enhances community engagement.[153.1] Moreover, involving community members in the research and assessment processes ensures that health interventions are culturally relevant and appropriately tailored to the community's unique context. This participatory approach helps address confidentiality concerns and ensures that the language used in health programs resonates with the community's cultural identity.[152.1] In addition to addressing immediate health needs, CHCs can leverage local cultural practices and historical assets to improve health equity. Understanding the cultural dynamics within rural communities is crucial for implementing successful health initiatives, as these factors significantly influence the acceptance and effectiveness of health programs.[161.1]In this section:
Future Directions
Research Needs and Opportunities
Rural healthcare is characterized by significant disparities compared to urban settings, necessitating targeted research to address these challenges. The American Hospital Association's Future of Rural Health Care Task Force has identified key trends and strategies that will shape the future of rural healthcare, emphasizing the need for innovative solutions and promising practices to improve care delivery and ensure the financial stability of rural hospitals.[190.1] Research indicates that rural Americans, who represent approximately 20% of the U.S. population, face unique health challenges, including higher rates of chronic diseases and limited access to healthcare services.[193.1] These disparities are exacerbated by workforce shortages, financial pressures, and evolving patient expectations, which necessitate a comprehensive understanding of past trends and current realities to strategically position rural hospitals for future success.[191.1] Moreover, the examination of health disparities between rural and urban populations reveals critical factors contributing to these inequities. Studies have shown that rural residents have lower access to health information and services, which can hinder their ability to make informed health decisions.[228.1] Additionally, life expectancy disparities between wealthier urban and poorer rural counties highlight the urgent need for focused research on social determinants of health and their impact on rural populations.[227.1] The Centers for Disease Control and Prevention (CDC) has published reports that delve into various aspects of rural health, including mortality rates, health-related behaviors, and access to mental health services, underscoring the importance of ongoing research in these areas.[226.1] Furthermore, the Health Equity Dashboard provides valuable insights into health equity metrics across rural, suburban, and urban counties, facilitating a better understanding of the health landscape and guiding future research initiatives.[229.1]Strategies for Improving Rural Health Access
Rural healthcare access can be significantly improved through the integration of technology and community-driven initiatives. Telemedicine has emerged as a transformative solution, allowing patients in remote areas to consult with specialists without the need for extensive travel, thereby addressing long-standing challenges such as distance and limited expertise in rural healthcare delivery.[198.1] The use of telehealth platforms not only enhances accessibility but also reduces costs associated with healthcare delivery, making it a viable option for many rural communities.[198.1] Moreover, leveraging text-based patient engagement technologies can further alleviate barriers to care by facilitating personalized communication pathways, remote physiologic monitoring, and bi-directional messaging.[195.1] This approach keeps rural communities connected to healthcare services, which is crucial given the significant scarcity of healthcare providers in these areas, with only 39.8 primary care physicians per 100,000 people compared to 53.3 in urban settings.[195.1] Data-driven strategies are also essential for identifying gaps in healthcare access and outcomes within rural populations. By engaging stakeholders—including community members, healthcare providers, and policymakers—rural communities can collaboratively design and implement targeted strategies that address their unique healthcare needs.[196.1] For instance, community health programs and community-directed healthcare interventions have been identified as effective strategies to provide essential health services close to home, thereby increasing access and coverage in low-income rural areas.[203.1] In addition to these technological and community-based strategies, addressing the barriers to health promotion and disease prevention is vital. Limited access to health promotion programs and healthcare services contributes to ongoing health challenges in rural areas.[201.1] Therefore, stakeholders must work to ensure that rural health policies are effectively implemented, taking into account the specific barriers faced by these communities.[202.1]References
[1] Perspective: The Importance of Healthy Rural Hospitals — Rural hospitals have been and always will be a critical part of the nation's health care delivery system. For nearly one-in-five Americans, they offer a caring and compassionate lifeline for individuals and families who would have few health care options otherwise.
[2] The Importance of Rural Healthcare - Southwest Health — Rural healthcare professionals are also often involved in preventative care programs, organizing community health screenings, education campaigns, and outreach efforts to ensure that patients have access to the resources they need to stay healthy.
[3] The Importance of Rural Health: Building a Strong Local Network — Discover the importance of rural health and how building strong local networks can reduce patient out-migration, improve care, and support community sustainability.
[4] The State of Rural Public Health: Enduring Needs in a New Decade — Public health in the rural United States is a complex and underfunded enterprise. While urban-rural disparities have been a focus for researchers and policymakers alike for decades, inequalities continue to grow. Life expectancy at birth is now 1 to 2 years greater between wealthier urban and rural counties, and is as much as 5 years, on average, between wealthy and poor counties. This
[5] Healthcare Access in Rural Communities Overview - Rural Health ... — Evidence-based Toolkits FORHP Funded Programs Starting Points Economic Impact Analysis Tool Community Health Gateway Testing New Approaches Care Management Reimbursement Rural Health Topics & States Topics Healthcare Access in Rural Communities More on this Topic On This Page Overview FAQs More in This Topic Guide Chart Gallery Resources Organizations Funding & Opportunities News Models and Innovations About This Guide Access to healthcare services is critical to good health, yet rural residents face a variety of access barriers. Access to healthcare is important for: Overall physical, social, and mental health status Disease prevention Detection, diagnosis, and treatment of illness Quality of life Avoiding preventable deaths Life expectancy Rural residents often encounter barriers to healthcare that limit their ability to obtain the care they need. For instance, to have healthcare access, rural residents must also have: Financial means to pay for services, such as health or dental insurance that is accepted by the provider Means to reach and use services, such as transportation to services that may be located at a distance, and the ability to take paid time off of work to utilize services Confidence in their ability to communicate with healthcare providers, particularly if the patient is not fluent in English or has limited health literacy Trust that they can use services without compromising privacy Confidence that they will receive quality care This guide provides an overview of healthcare access in rural America, including the importance and benefits of healthcare access as well as the barriers that rural residents experience. The guide includes information regarding: Barriers to care, including workforce shortages, health insurance status, transportation issues, health literacy, and stigma in rural communities Access issues for specific populations and healthcare services Strategies and resources to improve access Frequently Asked Questions How does the lack of healthcare access affect population health and patient well-being in a community?
[6] NRHA Rural Community Health Initiative - National Rural Health — NRHA's Rural Community Health Initiative is designed to support and promote the innovative programs in rural areas that aim to move health care beyond the four walls of the hospital, without undermining the sustainability of these community hospital anchors. This effort will highlight success happening in rural areas across the country with a special focus on the community-based programs under the 330A section of the Public Health Service Act. These programs provide funding to increase access to care in rural communities and to address their unique health care challenges. For more information on these grants and other programs, please consider visiting the Health Resources & Services Administration's (HRSA) Rural Community Programs website. NRHA has released the 2021 Rural Community Health Initiative Compendium of Best Practices, which highlights successful community-based programming in rural areas around the country.
[8] Health Promotion and Disease Prevention Program Challenges — Health Promotion and Disease Prevention Program Challenges - RHIhub Toolkit Rural Health Information Hub Rural Health Models & Innovations Rural Health Philanthropy Rural Health Works This topic guide offers the latest news, events, resources, and funding related to health promotion and disease prevention, as well as a comprehensive overview of related issues. Rural Health Rural Health Promotion and Disease Prevention Toolkit Health Promotion and Disease Prevention Program Challenges Prior to implementing rural health promotion and disease prevention programs, rural communities may need to address the following challenges: For more information, see Common Implementation Challenges in our Rural Community Health Toolkit. Establishing and Maintaining Public Health Infrastructure in Rural Communities
[9] The Challenges of Providing Preventive Health Care in Rural America — A recent report that addressed suicide issues and behavioral health access found that highly rural areas had fewer mental health facilities and fewer suicide prevention services when compared with those in more urban areas. 33 Other researchers studying rural challenges to behavioral health access in rural low-income areas note that there is a
[12] The State of Rural Public Health: Enduring Needs in a New Decade — The United States has surpassed 330 million in population, with more than 65 million living in rural jurisdictions. 1 There is a well-described urban-rural divide in the United States, where rural residents tend to be sicker and poorer and to have worse health behaviors than do their nonrural peers. 2-8 Rural challenges are not uniform and are complicated by geographic characteristics
[13] Determinants of rural-urban differences in health care provider visits ... — Provider shortages often coexist in rural communities with prevalent, adverse social determinants of health that serve to increase maternal mortality risk . ... (54.3% rural vs. 50.1% urban, p<0.05), although this was attributable to the greater rural likelihood of having had NP/PA visits (24.6% rural vs. 16.1% urban, p<0.05) since there
[14] Navigating Recent Policy Changes in Rural Health Care — Strengthening Rural Health Care with Policy and Innovation. The journey to enhance rural health care continues, combining thoughtful policy changes and innovative solutions. Strategies from Medicaid expansion to telemedicine integration are making headway in addressing longstanding disparities. These efforts ensure the sustainability of rural
[15] PDF — Telehealth policy changes during COVID-19 PHE Permanent Expired with PHE in 2023 Expires Dec. 31, 2024 Remove geographic originating site restrictions x Allow Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) to serve as distant site providers x Allow FQHCs and RHCs to serve as distant site providers for behavioral health services x Allow Medicare patients to receive telehealth services for behavioral health care in their home x Eliminate geographic restrictions for originating sites behavioral health services completed via telehealth x (in-person visit requirement suspended) Allow some behavioral services to be delivered using audio-only communication under certain conditions x (in-person visit requirement suspended) Allow Rural Emergency Hospitals to be originating sites for telehealth x Expand the list of providers eligible to provide Medicare telehealth services such as physical therapists, occupational therapists, speech language pathologists x Allow certain Medicare telehealth visits to be delivered using audio-only technology x Allow remote evaluations, checkups and visits to be provided to new patients17 x National Rural Health Association Policy Brief November 2024 5 These policy adaptations signify a broader acceptance and integration of telehealth into health care delivery systems.
[18] 5 Best Practices for Engaging Stakeholders in Rural Areas — Now that we've established the importance of rural engagement, here are five best practices and a few ways tools like Quorum can enhance your efforts in these communities. 1. Understand the Local Context. To effectively engage rural stakeholders, it's essential to start with a deep understanding of the community. Recognize Diversity: Rural
[19] Strategic Collaboration: The Key to Moving Rural Healthcare Forward — Strategic collaboration allows rural organizations to combine resources and expertise to improve care and patient outcomes. Southern Illinois Healthcare, the Iowa Primary Care Association, and Minnesota's Winona Community HUB share how strategic collaboration has helped them conduct community health needs assessments, provide technical assistance to community health centers, connect patients
[25] Artificial intelligence for access to primary healthcare in rural ... — Artificial intelligence for access to primary healthcare in rural settings - ScienceDirect Artificial intelligence for access to primary healthcare in rural settings Artificial Intelligence (AI) may enhance access to primary health care in rural settings, especially in areas with an underserved and rural populace, due to systemic challenges in infrastructure inadequacies, shortages of trained professionals, and poor preventive measures. This paper discusses the transformative roles of AI technologies in the efforts toward bridging these gaps by improving healthcare delivery and access. While AI, Internet of Things (IoT), and mobile health (mHealth) technologies create innovative solutions in remote monitoring and consultation, these technologies help promote prevention. No articles found. For all open access content, the Creative Commons licensing terms apply.
[35] Community Health in Rural America During the Mid-20th Century — Community Health in Rural America During the Mid-20th Century | Journal of Ethics | American Medical Association The Council on Rural Health (1945-1975) of the American Medical Association (AMA) collaborated with domestic health care organizations in the mid-20th century to improve access to health care in rural areas. Sewell, director of the Associated Women of the American Farm Bureau Federation, recognized the need for better health care in rural areas and engaged the medical profession. Because of her efforts, the American Medical Association (AMA) set up the Council on Rural Health (CRH) in 1945 to address rural health needs through annual conferences and community health councils. Conference conversations centered on community health councils as a way to channel medical guidance to the rural public.
[36] The State of Rural Public Health: Enduring Needs in a New Decade — Public health in the rural United States is a complex and underfunded enterprise. While urban-rural disparities have been a focus for researchers and policymakers alike for decades, inequalities continue to grow. Life expectancy at birth is now 1 to 2 years greater between wealthier urban and rural counties, and is as much as 5 years, on average, between wealthy and poor counties. This
[37] Health in Rural America: Remembering the Importance of Place — It is also important to think beyond the delivery of health and public health services in order to address the needs of rural areas. Many rural areas are undergoing major demographic and social transitions. For example, the outmigration of younger individuals contributes to the differential aging of rural populations.
[38] How Rural Medicine Is Evolving: Advances in Healthcare for Underserved ... — This article explores how rural medicine is evolving and the advances in healthcare that are helping to bridge the gap in access to care for underserved communities. From telemedicine to community health programs, the field of rural medicine is embracing change and making strides toward improving the health and well-being of those who live in rural areas.
[41] Rural Health Policy - Population Health in Rural America in 2020 - NCBI ... — The workshop's session on rural health policy introduced a variety of U.S. federal policies affecting rural health. It featured presentations on shifting rural health policy and practice toward value-based care, strategies for engaging health care providers to confront the health care crisis in rural America, the structure and function of tribal rural health policy, and the implications for
[45] Community Health Workers in Rural Settings - Models and Innovations — Effective Examples Kentucky Homeplace. Updated/reviewed October 2024. Need: Rural Appalachian Kentucky residents have deficits in health resources and health status, including high levels of cancer, heart disease, hypertension, asthma, and diabetes. Intervention: Kentucky Homeplace was created as a community health worker initiative to provide health coaching, increased access to health
[46] Exploring community engagement in place-based approaches in areas of ... — Exploring community engagement in place-based approaches in areas of poor health and disadvantage: A scoping review - ScienceDirect Exploring community engagement in place-based approaches in areas of poor health and disadvantage: A scoping review open access Developing trust is key to success in community-led, place-based initiatives. A scoping review was conducted to explore the characteristics, barriers, and enablers of community engagement in place-based approaches to improving health outcomes in a designated area of poor health and disadvantage. Trust, power, and cultural considerations were the most significant barriers and enablers to community participation in place-based approaches. Developing trust is key to success in community-led, place-based initiatives. Next article in issue No articles found. For all open access content, the relevant licensing terms apply.
[57] Community Health in Rural America During the Mid-20th Century — Community Health in Rural America During the Mid-20th Century | Journal of Ethics | American Medical Association The Council on Rural Health (1945-1975) of the American Medical Association (AMA) collaborated with domestic health care organizations in the mid-20th century to improve access to health care in rural areas. Sewell, director of the Associated Women of the American Farm Bureau Federation, recognized the need for better health care in rural areas and engaged the medical profession. Because of her efforts, the American Medical Association (AMA) set up the Council on Rural Health (CRH) in 1945 to address rural health needs through annual conferences and community health councils. Conference conversations centered on community health councils as a way to channel medical guidance to the rural public.
[58] AMA outlines 5 keys to fixing America's rural health crisis — AMA outlines 5 keys to fixing America’s rural health crisis | American Medical Association The AMA Update covers a range of health care topics affecting the lives of physicians and patients. What’s the news: With a recent report from the Centers for Disease Control and Prevention (CDC) showing that rural residents often live sicker and die younger than do their urban counterparts, the AMA has proposed five strategies the nation should take to improve rural health care access. Physician private practices are the backbone of rural health care for 46 million patients, but administrative burdens such as prior authorization and declining physician payment from Medicare and commercial insurers are exacerbating the challenges that these practices have in keep their doors open, AMA President-elect Bruce A.
[59] Continuing Challenges in Rural Health in the United States — In addition, residents of rural areas may have less access to public health interventions and health care services aimed at lung cancer prevention, screening and treatment (Fairfield et al., 2019). Among children with autism, caregivers report that access problems are exacerbated by services not being available in a given area, and these issues are greater for those children on the spectrum than those with other special health care needs (Benevides et al., 2016). (2017) J Rural Health 33(2): 167–179. (2019) J Rural Health 35(4): 560–565. (2001) J Rural Health 17(4): 328–331. (2017) J Rural Health 33(2): 146–157. (2009) J Rural Health 25(4): 358–365.
[60] A (Brief) History of Health Policy in the United States - PMC — The Kerr-Mills Act was passed, which used federal funds to support state programs providing medical care to the poor and elderly (a precursor to Medicaid).6 In 1961, the White House Conference on Aging was held, in which the task force recommended health insurance for the elderly under Social Security. The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996, restricting the use of pre-existing conditions in health insurance coverage determinations, setting standards for the privacy of medical records, and favorably taxed long-term care insurance.8 In that same year, the Personal Responsibility and Work Opportunity Act removed the link between Medicaid and cash assistance eligibility, and allowed states to cover parents and children at higher rates.
[76] Healthcare Access in Rural Communities Overview - Rural Health ... — Evidence-based Toolkits FORHP Funded Programs Starting Points Economic Impact Analysis Tool Community Health Gateway Testing New Approaches Care Management Reimbursement Rural Health Topics & States Topics Healthcare Access in Rural Communities More on this Topic On This Page Overview FAQs More in This Topic Guide Chart Gallery Resources Organizations Funding & Opportunities News Models and Innovations About This Guide Access to healthcare services is critical to good health, yet rural residents face a variety of access barriers. Access to healthcare is important for: Overall physical, social, and mental health status Disease prevention Detection, diagnosis, and treatment of illness Quality of life Avoiding preventable deaths Life expectancy Rural residents often encounter barriers to healthcare that limit their ability to obtain the care they need. For instance, to have healthcare access, rural residents must also have: Financial means to pay for services, such as health or dental insurance that is accepted by the provider Means to reach and use services, such as transportation to services that may be located at a distance, and the ability to take paid time off of work to utilize services Confidence in their ability to communicate with healthcare providers, particularly if the patient is not fluent in English or has limited health literacy Trust that they can use services without compromising privacy Confidence that they will receive quality care This guide provides an overview of healthcare access in rural America, including the importance and benefits of healthcare access as well as the barriers that rural residents experience. The guide includes information regarding: Barriers to care, including workforce shortages, health insurance status, transportation issues, health literacy, and stigma in rural communities Access issues for specific populations and healthcare services Strategies and resources to improve access Frequently Asked Questions How does the lack of healthcare access affect population health and patient well-being in a community?
[77] The State of Rural Public Health: Enduring Needs in a New Decade — The United States has surpassed 330 million in population, with more than 65 million living in rural jurisdictions. 1 There is a well-described urban-rural divide in the United States, where rural residents tend to be sicker and poorer and to have worse health behaviors than do their nonrural peers. 2-8 Rural challenges are not uniform and are complicated by geographic characteristics
[78] State Legislatures Moving to Increase Rural Healthcare Access — Jurisdictions have also pursued tax policy changes aimed at supporting rural healthcare providers, including state tax credits for individual practitioners working in rural areas. In 2024, Georgia amended its rural physician tax credit to include dentists living and working in rural areas. In 2025, at least two states are considering expansion
[79] AMA outlines 5 keys to fixing America's rural health crisis — AMA outlines 5 keys to fixing America’s rural health crisis | American Medical Association The AMA Update covers a range of health care topics affecting the lives of physicians and patients. What’s the news: With a recent report from the Centers for Disease Control and Prevention (CDC) showing that rural residents often live sicker and die younger than do their urban counterparts, the AMA has proposed five strategies the nation should take to improve rural health care access. Physician private practices are the backbone of rural health care for 46 million patients, but administrative burdens such as prior authorization and declining physician payment from Medicare and commercial insurers are exacerbating the challenges that these practices have in keep their doors open, AMA President-elect Bruce A.
[80] Exploring Historical Policies Impacting Rural Healthcare Access — Running Head: Historical Policies Shaping Rural Healthcare Access Today 2 Poor access to health care in rural settings results from historical policy and other systemic socio-economic factors. One recent review asserts, "the current system symbolizes the lack of perceived economic and social value of rural places" (Afifi et al., 2024). Therefore, this paper focuses on some historical policies
[83] PDF — To this point, the Rural Policy Research Institute (RUPRI) Health Panel has called attention to the impact of unintended consequences of policy changes on rural communities for decades, from in-depth analyses of major legislative policies (i.e., Balanced Budget Act of 1997, the Patient Protection and Affordable Care Act of 2010 [PPACA]) to analysis of reform efforts in public payer programs to rapid responses to new rules and regulations via Comment Letters.3,5,6,7,8 One example of a potential unintended consequence impacting rural populations and providers occurred after passage of the PPACA and new rules affecting beneficiary assignment to Medicare Shared Savings Program Accountable Care Organizations (ACOs).
[84] Socioeconomic and Systemic Barriers in Rural Healthcare — This is a significant source of anxiety for stakeholders in rural communities, as evidenced by Margot Barnhardt’s testimony : _“_I think our healthcare is in a terrible state for this wealthy country…so many people can’t afford health insurance, and they aren’t covered.” An issue brief by the Kaiser Commission on Medicaid and the Uninsured Approximately further expands on Barnhardt’s testimony by providing an analytical characterization of the issues faced by rural health stakeholders. As someone who worked at a community health center, Hinga details, “We’ve got so many requirements…meaningful use, joint commission, CMS, HRSA… in order to meet those requirements you have to train and educate people including providers.” When community health centers must serve such a heavy burden as a result of being underfunded in rural areas, they are not able to provide outreach efforts and careful care to communities being disproportionately impacted by low socioeconomic status, physical and sociocultural barriers to healthcare.
[86] Enhancing Healthcare Access in Rural America: Overcoming Challenges and ... — Addressing the challenges of rural healthcare access requires innovative solutions that consider the unique needs of these communities. By leveraging local resources and community engagement, these models can enhance healthcare access and improve health outcomes for rural populations. Federal and state governments have implemented various programs to support rural healthcare providers and improve access to care. Funding initiatives such as the Rural Health Care Program provide financial support for telecommunication services in rural healthcare facilities. Project ECHO (Extension for Community Healthcare Outcomes) is an innovative model that uses tele-mentoring to expand access to specialty care in rural areas. Telehealth, community health workers, policy interventions, and successful models like Project ECHO and the Alaska Community Health Aide Program offer valuable insights into effective strategies for overcoming rural healthcare challenges.
[87] What improves access to primary healthcare services in rural ... — Twenty-four (21.8%) of the full-text articles included in this review discussed that community health programs (CHPs) or community-directed healthcare interventions are best strategies to provide basic health and medical care close to the community to increase access and coverage of essential health services. In this systematic review of literature, 11 (10%) of the included articles discussed that community health funding schemes such as community-based health insurance (CBHI) increases access to healthcare services in low-income rural communities. This systematic literature review found that community health programs or community-directed healthcare interventions, school-based healthcare services, student-led healthcare services, outreach services or mobile clinics, family health program, empanelment, community health funding schemes, telehealth, integrative medicine, and working with non-profit private sectors and NGOs are key strategies to improve access to PHC services in rural communities.
[89] NRHA's Rural Health Voices Blog | National Rural Health Association ... — Rural communities contend with a significant scarcity of health care providers, with 68 physicians per 100,000 people compared to 80 in urban areas. By leveraging data to identify gaps in health care access and outcomes, rural communities can develop targeted strategies to improve health care delivery. Stakeholder engagement also plays a crucial role in this process, bringing together community members, health care providers, and policymakers to collaboratively design and implement solutions that meet the unique needs of rural populations. The closure of rural hospitals leaves communities stranded in health care deserts. In the face of hospital closures, telehealth again emerges as a beacon of hope, transcending geographical barriers and delivering vital health care services to rural America.
[112] How Rural Medicine Is Evolving: Advances in Healthcare for Underserved ... — This article explores how rural medicine is evolving and the advances in healthcare that are helping to bridge the gap in access to care for underserved communities. By expanding access to specialist care, telemedicine is improving health outcomes, reducing wait times, and making healthcare more convenient and affordable for rural residents. Mobile health clinics are another key advancement in rural medicine, helping to bring healthcare directly to underserved communities. In rural communities, where healthcare professionals are often scarce, community health workers (CHWs) play a vital role in improving health outcomes and increasing access to care. Advances such as telemedicine, mobile health clinics, community health workers, rural residency programs, and health information technology are helping to bridge the gap in healthcare access for underserved populations.
[113] A New Era for Rural Healthcare: Innovations Shaping Access in 2025 — A New Era for Rural Healthcare: Innovations Shaping Access in 2025 - Total RCM Solutions By 2025, healthcare providers in rural communities will use AI-powered tools to monitor patients’ health remotely, alerting doctors to potential issues before they become critical. As rural healthcare centers increasingly adopt digital health records, patients’ medical histories will be accessible to any provider, regardless of location. With the combination of technology, community-focused solutions, and policy shifts, healthcare in rural areas will become more accessible, affordable, and patient-centered. Whether through telehealth consultations, mobile clinics, or AI-powered preventive care, rural communities will be better equipped to handle their healthcare needs without having to travel great distances or wait for essential services. Address : Sri Sri Sai Arcade, 1034A, 24th Main, 9th Cross, Sector 1, HSR Layout, Bangalore 560102
[118] A Comprehensive Review on Exploring the Impact of Telemedicine on ... — Case studies/examples: Telemedicine has emerged as a pivotal tool in enhancing geographical accessibility to healthcare, offering significant potential to mitigate health disparities by granting individuals in rural or underserved areas access to essential medical services . Through concerted efforts to overcome barriers and enhance accessibility, mobile health units can effectively extend the reach of telemedicine services to underserved populations, promoting health equity and improving healthcare outcomes in remote areas. By proactively addressing these barriers and implementing strategic interventions, healthcare providers can enhance patient acceptance and utilization of telemedicine, ultimately facilitating improved access to quality healthcare services. By bridging geographical barriers and expanding access to care for underserved communities, including those in rural areas, remote regions, and areas with limited healthcare resources, telemedicine can significantly reduce healthcare disparities and improve health outcomes for vulnerable populations .
[119] NRHA's Rural Health Voices Blog | National Rural Health Association ... — For example, rural hospitals use telehealth technologies for telecardiology, telestroke, teleneurology, and telebehavioral health, ensuring that patients with critical conditions like stroke receive care within the "golden hour," a crucial window for intervention that would otherwise be lost during transfers to distant facilities (Fairchild, 2019; Tsou et al., 2021). Telehealth is a powerful tool for addressing the health care disparities faced by rural hospitals, particularly in enhancing access to specialty care and improving patient outcomes in emergency situations. By implementing targeted policies, fostering collaboration between hospitals, and expanding access to high-speed internet, telehealth can help bridge the gap in health care access for rural populations and ensure patients in these communities receive the timely, high-quality care they deserve.
[120] Role of AI in Rural Healthcare Accessibility - medtechmunch.com — AI technologies can bridge the gap between urban and rural healthcare by providing remote diagnostics, telemedicine, and personalized treatment plans, thus overcoming geographical barriers. AI-driven tools can analyze medical data efficiently, enabling early detection of diseases and reducing the need for in-person consultations.
[121] 10 Ways AI is Transforming Rural Healthcare: Bridging Gaps and ... — By leveraging AI technologies, rural healthcare systems can bridge gaps, enhance patient outcomes, and empower communities to access high-quality care regardless of geographical constraints. By leveraging AI tools that analyze patient data, suggest treatment options, and offer real-time guidance, rural healthcare providers can enhance their clinical decision-making, deliver more personalized care, and improve patient outcomes. AI has the potential to address healthcare disparities in rural communities by facilitating proactive care management, preventive interventions, and health education initiatives. By analyzing population health data, identifying social determinants of health, and predicting health risks, AI technologies enable healthcare providers to tailor interventions that address the specific needs of rural populations. By enhancing access to care, optimizing resource allocation, improving diagnostic accuracy, empowering healthcare professionals, and addressing healthcare disparities, AI has the potential to revolutionize rural healthcare.
[122] Telemedicine and AI to Improve Healthcare Access in Rural Settings — Integrating telemedicine and artificial intelligence (AI) presents a promising solution to enhance healthcare access and quality in rural settings, where limited medical resources and geographical barriers pose significant challenges. AI-driven diagnostic tools, integrated with telemedicine platforms, can analyze medical data, including imaging, electronic health records (EHRs), and real-time patient monitoring, to assist healthcare providers in making accurate and timely decisions. In conclusion, the integration of telemedicine and AI holds significant potential to revolutionize healthcare access and delivery in rural settings. Integrating Telemedicine and AI to Improve Healthcare Access in Rural Settings In conclusion, AI's integration into rural healthcare systems significantly improves the early diagnosis of chronic diseases, offering a scalable solution to address the disparities in healthcare access and outcomes between urban and rural populations.
[146] The Role of Community Engagement in Achieving Sustainable Rural Development — Community engagement is the bedrock of sustainable rural development. It ensures that development initiatives are not only more effective but also inclusive, equitable, and long-lasting. By involving local populations, respecting their knowledge, and fostering a sense of ownership, development projects can thrive and bring about real change.
[147] Community engagement: a health promotion guide for universal health ... — WHO has defined community engagement as "a process of developing relationships that enable stakeholders to work together to address health-related issues and promote well-being to achieve positive health impact and outcomes". There are undeniable benefits to engaging communities in promoting health and wellbeing.
[148] Community Readiness and Engagement - Rural Health Info — Community Readiness and Engagement - Rural Health Promotion and Disease Prevention Toolkit This topic guide offers the latest news, events, resources, and funding related to health promotion and disease prevention, as well as a comprehensive overview of related issues. Rural Health Successful health promotion and disease prevention programs rely on involvement from the community. During program planning and implementation, rural communities should consider community perception and readiness to help, which may differ by intended population and by the health topic or issue being addressed. For more information on how CHWs support community organization, visit the Community Health Workers Toolkit. Provides materials designed to help communities plan, conduct, and evaluate health promotion and disease prevention programs using the PATCH process.
[149] Identify Community Needs and Assets - Rural Health Info — Identify Community Needs and Assets - RHIhub Community Health Toolkit Rural Community Health Toolkit The first step in preparing to develop a community health program is identifying community needs and priorities. Conducting a community health needs assessment can help rural programs determine where and how to use limited resources to address health-related needs. For more information on how to conduct a needs assessment, see Conducting Rural Health Research, Needs Assessments, and Program Evaluations. Mapping community assets can also help rural communities identify needs and priorities for health programming. Community Health Assessment and Improvement Planning Community Health Assessment Toolkit: Prioritize Community Health Needs and Assets Community Health Maps
[152] Conducting Rural Health Research, Needs Assessments, and Program ... — Conducting Rural Health Research, Needs Assessments, and Program Evaluations Overview - Rural Health Information Hub Conducting Rural Health Research, Needs Assessments, and Program Evaluations Given the importance of research, assessment, and evaluation to rural interventions and policy, the best rural health research and community assessments include a member of the community as a member of the research team helping to ensure that the community’s confidentiality concerns are addressed, programs are appropriate, and language is accurate and reflects the culture of the community. When should we conduct a needs assessment and plan the program evaluation for our rural community health project? When should we conduct a needs assessment and plan the program evaluation for our rural community health project?
[153] Community Needs Assessment Survey: Examples and Overview — Community Needs Assessment Survey: Examples and Overview - School of Public Health Community needs assessment surveys can help identify and address these health inequalities. A community needs assessment offers comprehensive information about the health needs, critical issues, and resources of a specific community. A successful community needs assessment survey also strengthens community-based partnerships, increases knowledge about community health, and fosters community engagement. The primary goal of a community needs assessment is to identify the physical, mental health, social, or public health needs in the community. A needs assessment offers a comprehensive look at a community’s public health, physical, and social needs. Community Needs Assessments and Public Health Outcomes Community needs assessment surveys can improve public health outcomes.
[154] Addressing the need for health equity reform in rural community ... — Within these major themes, subthemes were elucidated. Amplifying the concerns and successful strategies of rural hospital stakeholders may provide solutions to address the health crisis affecting rural communities throughout the US and advance rural health equity.
[155] PDF — Further, a physician in a community translates into actual revenue and real jobs.viii A 2016 report from the National Center for Rural Health Works estimates that a rural primary care physician can generate more 2 February 2023 than $1.4 million in wages and salaries and contribute 26.3 jobs to a local community with a hospital.ix Some specific examples of how local health care services can impact the economy include: • A 2017 USDA study, which found that inpatient health care facilities were responsible for 1.25 million jobs, or 8.5 percent of wage and salary employment, in rural communities at their peak in 2011.x • When a local health care facility offers an essential service such as dialysis, people stay in the community for care instead of traveling to urban centers and investing there.
[156] Addressing Health Disparities through Community Participation: A ... — Addressing Health Disparities through Community Participation: A Scoping Review of Co-Creation in Public Health - PMC Conclusions: Co-created public health actions offer the opportunity to reduce health inequity and promote social change; yet, further effort is needed to involve communities in the entire cycle of decision making. The scoping review was carried out to answer the research question: “What methods have been used in co-created public health actions that incorporate the principle of equity, how does community or citizen participation tend to be articulated, and what effects on health and equity have been observed?”. Participatory methodology, equity focus, and community participation in 31 co-created public health actions reviewed. 24.Israel B.A., Schulz A.J., Parker E.A., Becker A.B. Review of Community-Based Research: Assessing Partnership Approaches to Improve Public Health.
[161] PDF — Recommendations to Leverage Rural and Cultural Assets to Improve Health and Equity The culture and history of rural communities was described as a critical factor in determining whether and how changes are implemented to improve health and well-being. Identified strategies for leveraging cultural and historical assets include:
[162] Strengthening Patient Relationships in Rural Healthcare Settings — Community Engagement: Building Trust and Connection. Community engagement is a cornerstone of effective healthcare delivery in rural areas. Establishing trust and rapport between healthcare providers and the community can lead to improved patient satisfaction and adherence to treatment plans. Here are several strategies to enhance community
[164] How Can Rural Healthcare Achieve Success and Overcome Challenges? — Community engagement is a vital component of successful rural healthcare. Caregivers should integrate into their communities by participating in leadership boards, volunteering, and attending local events. This involvement helps build trust and fosters strong relationships within the community, which is essential for effective healthcare delivery.
[165] Community Trust And Relationships: The Key For ... - Health Affairs — Over the years, ChangeLab Solutions—the public health law and policy organization led by Sarah (one of this article’s authors)—worked with local governments, including local health departments, to effectively and meaningfully engage community leaders and organizations in planning, policy making, and infrastructure-building efforts. Governments can use funding to partner with CBOs to support these efforts and expand other services that successfully engage community residents such as community health workers and promotora programs. Build community trust through shared decision making: State and local health departments should engage in opportunities to build long-term relationships with community residents that are not timebound and tied to specific projects, and should work with community leaders to facilitate the engagement process.
[190] Final Recommendations: Future of Rural Health Care Task Force, May 2021 — AHA's Future of Rural Health Care Task Force has released a report with recommendations for long-range solutions for improving rural health and health care in America. Read more for the innovative solutions and promising practices for care delivery, as well as models to ensure the financial stability of rural hospitals and access to care for rural residents.
[191] Rural Healthcare Trends and Strategies for 2025 — Rural healthcare plays a pivotal role in ensuring access to medical services for millions of Americans. However, these facilities face unique challenges, including workforce shortages, financial pressures, and evolving patient expectations. By understanding past trends, current realities, and future predictions, rural hospitals can strategically position themselves to thrive in 2025 and beyond
[193] State health disparities research in Rural America: Gaps and future ... — Rural Americans, who comprise 20% of the US population (one in five Americans) and nearly 60 million people, face disparities that result in worse health care than that of urban and suburban residents. 1 More than 90% of US landmass is rural, defined as any population, housing, or territory not in an urban area. According to a 2015 National Rural Health Association study, the death rate for
[195] Improving Rural Health and Access to Care with Digital Health Tools — Leveraging text-based patient engagement technology can alleviate many of those barriers through personalized communication pathways, remote physiologic monitoring, and bi-directional messaging, keeping rural communities conveniently and safely connected to care. The National Rural Health Association reports that the patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 people, compared to 53.3 physicians per 100,000 in urban areas. For example, in an idealized rural rheumatology care network, physicians may see patients from 10 or 20 counties — which is only possible if the right technology is in place. Digital patient engagement can help close care gaps for patients in rural communities and help generate personalized communication workflows based on patient preferences, response to treatment, and social determinants of health — keeping rural communities conveniently and safely connected to care.
[196] NRHA's Rural Health Voices Blog | National Rural Health Association ... — Rural communities contend with a significant scarcity of health care providers, with 68 physicians per 100,000 people compared to 80 in urban areas. By leveraging data to identify gaps in health care access and outcomes, rural communities can develop targeted strategies to improve health care delivery. Stakeholder engagement also plays a crucial role in this process, bringing together community members, health care providers, and policymakers to collaboratively design and implement solutions that meet the unique needs of rural populations. The closure of rural hospitals leaves communities stranded in health care deserts. In the face of hospital closures, telehealth again emerges as a beacon of hope, transcending geographical barriers and delivering vital health care services to rural America.
[198] Telehealth and digital tools enhancing healthcare access in rural ... — 1.3 Role of technology in advancing rural health care. Technology is poised to revolutionize rural healthcare by enhancing access to care, reducing costs, and improving patient outcomes. Advances in telemedicine allow remote patients to receive expert care from their homes, making healthcare more accessible and cost-effective.
[201] Barriers to Health Promotion and Disease Prevention in Rural Areas — Barriers to Health Promotion and Disease Prevention in Rural Areas - RHIhub Toolkit Rural Health Information Hub Rural Health Models & Innovations Rural Health Philanthropy Rural Health Works This topic guide offers the latest news, events, resources, and funding related to health promotion and disease prevention, as well as a comprehensive overview of related issues. Rural Health Rural Health Promotion and Disease Prevention Toolkit Barriers to Health Promotion and Disease Prevention in Rural Areas Limited access to health promotion and disease prevention programs and healthcare services contribute to these health challenges. The Rural Health Information Hub is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Number U56RH05539 (Rural Assistance Center for Federal Office of Rural Health Policy Cooperative Agreement).
[202] Rural Health Policy Overview - Rural Health Information Hub — Along with the Federal Office of Rural Health Policy (FORHP), the following agencies work to address rural health policy issues: Provides a forum for rural mental health professionals, consumers, and advocates to identify issues, share models and innovations, and inform state and national rural mental health policy. Several government agencies, membership organizations, research centers, and nonprofit organizations at the national and state levels serve as resources to stay current on rural health policy issues. The Rural Health Information Hub is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Number U56RH05539 (Rural Assistance Center for Federal Office of Rural Health Policy Cooperative Agreement).
[203] What improves access to primary healthcare services in rural ... — Twenty-four (21.8%) of the full-text articles included in this review discussed that community health programs (CHPs) or community-directed healthcare interventions are best strategies to provide basic health and medical care close to the community to increase access and coverage of essential health services. In this systematic review of literature, 11 (10%) of the included articles discussed that community health funding schemes such as community-based health insurance (CBHI) increases access to healthcare services in low-income rural communities. This systematic literature review found that community health programs or community-directed healthcare interventions, school-based healthcare services, student-led healthcare services, outreach services or mobile clinics, family health program, empanelment, community health funding schemes, telehealth, integrative medicine, and working with non-profit private sectors and NGOs are key strategies to improve access to PHC services in rural communities.
[226] Rural Health Disparities — Published in 2017-2018, the Centers for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report (MMWR) Rural Health Series examines rural mortality and preventable deaths, health-related behaviors, chronic disease, mental health services, and other topics related to rural health disparities. The 2019 National Healthcare Quality and Disparities Report: Chartbook on Rural Health Care from the Agency for Healthcare Research and Quality includes a section on healthy living, covering data on health behaviors, smoking, and other health disparity data with rural and urban comparisons throughout. Offering additional information on regional rural health disparities, the U.S. Health Map from IHME at the University of Washington is an interactive map that provides county-level data for the U.S. on life expectancy, mortality rates, mortality risks, and other health risk factors.
[227] The State of Rural Public Health: Enduring Needs in a New Decade — Public health in the rural United States is a complex and underfunded enterprise. While urban-rural disparities have been a focus for researchers and policymakers alike for decades, inequalities continue to grow. Life expectancy at birth is now 1 to 2 years greater between wealthier urban and rural counties, and is as much as 5 years, on average, between wealthy and poor counties. This
[228] Differences in Rural and Urban Health Information Access and Use — Compared to urban residents, rural residents had lower access to health information from sources including primary care providers, specialist doctors, blogs, and magazines, and less use of search engines. [Yes/No].” We asked these 2 questions for each of 25 health information sources that were adapted from the Health Information National Trends Survey31 and the Pew Research Center.32,33 Then, we grouped the 25 sources into 6 categories: (1) health professionals: primary care providers, nurses, specialist doctors, pharmacists, veterinarians, and dentists; (2) lay individuals: friends, family, religious organizations and leaders; (3) health authorities: health fairs, local health department, federal government organizations, scientists, and scientific literature; (4) online sources: search engines, social media, medical websites, and blogs or celebrity webpages; (5) mass media: newspapers, magazines, books, television, and radio; (6) companies: pharmaceutical companies, and other companies or corporations (eg, the retailer GNC (GNC Holdings Inc., Pittsburgh, PA)). Compared to urban residents, rural residents have lower access to several common sources (eg, primary care providers and specialist doctors) and less use of search engines for health information.
[229] Rural-urban disparities in health outcomes, clinical care, health ... — A national map view of the Health Equity Dashboard, showing: the 2019 distribution in quintiles of a national index formed from five measures (life expectancy, percentage of the adult population that is obese, percentage of the population that is uninsured, income inequality, and air quality) and the percentage of rural, suburban, and urban counties with index values in the best to worst quintiles (top); the county-level distribution of that index across urban, suburban, and rural county designations (middle); and a comparison of the 2015 and 2019 values of one measure (percentage of the population in fair or poor health) at the state level (bottom).