UP News & Highlights

Health disparities occur in all regions of the country and in different populations. Rural and frontier regions have their unique barriers as well as opportunities.

• Approximately one in five Americans live in rural areas
• 75% of all counties in the U.S. are considered rural (Warren, J.C., & Smalley, K.B., 2014)
• 39% higher emergency department visits in U.S. for people living in rural areas compared with those living in urban areas (515 visits vs. 372 visits per 1,000 people) (AHRQ, 2011) 

Warren and Smalley (2014) state the two most important challenges for people living in rural areas are poverty and access to basic health care (including transportation). Rural residents are more likely to live below poverty level and often do not have health insurance. Agriculture is one of the main employment opportunities in many rural areas, but this is a highly unpredictable market.

Many states have or will be expanding their Medicaid program eligibility. Check here to find out information about your state (select the state in the box on the right). Keep current with the changes and set up a process to assess for patients that may now qualify. Remember to be sensitive to this population's characteristics that may distrust public services and still look as assistance as a stigma in the community.

HealthCare.gov's open enrollment ends March 31, 2014. Ask patients if you can check if they are eligible for tax rebate for healthcare. Use the Kaiser Family Foundation calculator to get an estimate or provide patient or family with internet link (www.healthcare.gov) or phone number (1-800-318-2596).

Health Resources and Services Administration (HRSA) is a division of the U.S. Department of Health and Human Services. HRSA programs include health centers that are based upon a person's income (with or without insurance). Most cites and many rural areas have a HRSA Clinic, but many more are needed. Click here to see if there is a center near you.

Most rural communities do not have reliable public transportation and patients typically have to travel more than 30 minutes for care. Warren & Smalley (2014) state the strong presence of community groups can be an asset for some rural barriers. Develop or participate with an interfaith volunteer network to assist with transportation needs. Many times, there are retirees that are willing to drive as well as a member to coordinate this service.

Health and Human Services (HHS) awarded $55.5 million in funding for the fiscal year 2013 to focus on training and increasing the healthcare workforce development. $45.4 million will support nursing workforce development including nursing faculty, nursing diversity, nurse anesthetist traineeships, promoting collaborative practice, and advancing nursing education (e.g., RNs to Nurse Practitioners).  Click here to read more.

Tools/Resources of the Month

Rural Assistance Center (RAC) - Health and Human Services Information for Rural America 

• Tools and resources
• Sort by topic or state
• Tools for Success
• Spotlights
• Online funding and opportunities
• Establish collaborations now and plan out potential projects to be ahead of the deadlines for grants; think out of the box for partners (e.g., PCP practices, Safety Net providers, faith-based churches, Area on Aging, local community organizations)
• Rural Updates mailing list

Warren, J.C., & Smalley, K.B. (2014). Rural public health - Best practices and preventive models. New York, NY:  Springer Publishing Company.