Healthcare Disparities in the Rural Population Amy Haines Michael Klein

Introduction There are clear and well documented disparities in the provision of health care between the rural and urban settings. These disparities have strong implications for nursing as the profession attempts to provide equal health care for all individuals Rural communities are in need of better health care. This is a major concern for nursing as it seeks to provide equal health care and eliminate health care disparities.

Objectives Identify and discuss 3 factors that put rural communities at risk for health care disparities Discuss what factors have led to or caused health disparities Discuss 2 ways that nursing meet the health care needs of rural communities

Assessment of the healthcare environment According to the U.S. Department of Health and Human Services rural can be defined as “all population, housing, and territory not included within an urban area” (2015). Rural communities make up 25% of the American population, but 97.5% of the land (Harkness & DeMarco, 2012). Already apparent are the health care difficulties presented when such a high percentage of land is rural. US Department of Agriculture Economic Research Services define rural as places with fewer than 2500 people. Distance traveled for work, health care, emergency aid, law enforcement, etc. is problematic for the rural communities.

Assessment cont. According to the U.S. Department of Health and Human Services (2015) rural communities tend to: Have higher poverty rates Have higher percentages of elderly Have fewer physicians, hospitals, and health care agencies As an extension of rural communities relative isolation it becomes harder for individuals in this area to gain access to basic life needs. Compounded to this there is a lack of health care providers in rural areas; approximately 10% of physicians practice in rural communities while rural communities represent 25% of the total population

Assessment cont. Distance and lack of resources have strongly undermined quality health care in rural America According to the National Rural Health Association (2015): People in rural communities tend to rely more heavily on government assistance People in rural communities are less likely to have employer- provided health insurance Rural health care providers and hospitals receive less compensation from Medicare Rural areas experience a greater rate of accidents with slower response times Rural residents have high rates and risk for chronic disease While rural communities have inherent disadvantages (e.g. far travel distances, etc.) a lack of Medicare compensation deters health care professionals from working with this population and has contributed to the closing of 470 rural hospitals over the past 25 years (National Rural Health Association, 2015).

Root Cause Analysis There are many health concerns of rural communities, however these concerns may be traced back to decreased access Healthy People 2010’s number 1 priority for improving health care in rural communities is increasing access to health care Although there are several factors related to the present health disparities among the rural communities many of them spring from geographical locations and their implications. These implications may include distance from work, education, health care facilities, law enforcement, neighbors, support, etc.

Implications Rural health disparities are present in a variety of ways: educationally, socially, economically, etc. With attention to these obstacles health care professionals care begin to understand the needs of rural America It is important to first understand what is needed: why is there a problem? What are contributing factors? What can be done by health care professionals to address these problems?

Implications Rural America represents a significant portion of the population – 25% Addressing the health care needs should be a primary focus as they represent a group that experiences decreased health care options but increased governmental aid Initiating early interventions can decrease costs of and need for acute care Early intervention has proven to be a key factor in maintaining health. It is important to begin early education especially for this group to decrease risky behaviors (e.g. drunk driving, smoking, etc.). Doing so is more cost effective and will benefit long term health.