2. Healthcare Disparities in the Rural Population Amy Haines Michael Klein

3. 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

4. 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

5. 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).

6. 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

7. 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

8. 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

9. 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

10. 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

11. Recommendations  It is important for nurses and health care professionals to be able to identify what puts a person at risk for health disparities  Nurses that work in rural communities should make an effort to understand cultural characteristics  Once a risk for health disparity is identified health care workers may need to focus special attention on the community in question

12. Recommendations  Rural areas have great risk for health disparity. Nurses are able to close the gap somewhat:  Primary care providers (e.g. advance practice nurses) may provide primary care to rural areas  Nurses are able to raise funding for health care in rural areas  Nurses are able to provide community nursing to rural areas with focus on disease prevention, management of chronic diseases, and health promotion  Nurses can draw national attention to health disparities among the rural community

13. Recommendations  As interventions are made it is important to conduct follow up research: Did the intervention work?  Before, during, and after the intervention the worker should make an effort to review comparable situations and the success or failure of those situations

14. Conclusion  Rural areas are at high risk for health disparities related to many factors such as geography, culture, socioeconomic status, etc.  Health care is underrepresented in rural communities  This population represents a great need for intervention due to its size and the severity of health disparities  Nursing and health care have to opportunity to intervene and improve health care in rural America

15. References  Harkness, G. & DeMarco, R. (2012). Community and public health nursing: Evidence for practice. Philadelphia, PA: Lippincott Williams & Wilkins  National Rural Health Association. (2015). What's different about rural care? Retrieved from: http://www.ruralhealthweb.org/go/left/about-rural-health  U.S. Department of Health and Human Services. (2015). Policy & research. Retrieved from: http://www.hrsa.gov/ruralhealth/policy/index.html