There is a powerful link between social factors and health.
Rural multicultural and multiracial populations face a combination of factors that create disparities in health care that are not always found in urban areas. Economic factors, cultural and social differences, educational shortcomings, the challenges of developing a national strategy to deal with these issues, and the sheer isolation of living in remote rural areas all conspire to impede rural Americans in their struggle to lead a normal, healthy life.
Living in a rural area is in itself a health risk factor that can adversely influence health; therefore, minorities living in rural areas face the double burden of health risk factors based on rural residence and health disparities.
Attention to rural racial and ethnic disparities in care has increased among policymakers. However, efforts to develop a national strategy to address these health disparities has proven difficult because of the many factors driving this public health problem.
Many rural minorities are employed in occupations that involve exposure to environmental hazards and injury. These problems are compounded by a shortage of health care providers and limited access to health care. Barriers unique to rural health care delivery systems include long travel distances to obtain health care, low population densities, lack of economies of scale and the high cost of opening a health care center to provide care for so few people.
The shortage of health care providers is an even greater issue when addressing rural racial and ethnic disparities as there is evidence that a black or Hispanic patient is more likely to seek care from a clinician of their own race because of personal preference or language, and not only because of geographic proximity.
Minorities are seriously under-represented in health professions, and the situation is not improving. Blacks, Hispanic Americans, and American Indians and Alaska Natives as a group comprise nearly 25 percent of the US population. These populations account for less than 9 percent of nurses, 6 percent of physicians, and only 5 percent of dentists. A health care workforce that is sensitive to the needs and cultures of these many diverse rural populations not only ensures that services are available but also accessible and relevant for the service area or target population. As a result, research documenting patterns of minority and rural disadvantage shows that blacks and Hispanics tend to have limited access to health care services, lower health care utilization rates, and lower rates of insurance than whites.
Higher rates of certain diseases and disabling conditions, such as heart disease, asthma, obesity, and infant mortality are most common in low-income communities and communities of color. It’s important to note that while only one in six Americans are rural, one in five of the nation’s uninsured are rural.
Social and economic policies directly impact the health and well-being of those who live and work under them. As such, key strategies to address these shortcomings must include: efforts to increase the nation’s usage of telemedicine, community awareness of health disparities, improved data collection, and cultural competency training among health care professionals.
Opportunities to improve rural health disparities most certainly exist, but a recognition and understanding of the many challenges facing rural minority populations are a necessary first step to addressing these health disparities.
Blog Author
Alan Morgan,
CEO of the National Rural Health Association
Alan Morgan serves as Chief Executive Officer for the National Rural Health Association. He has more than 24 years experience in health policy development at the state and federal level. He served as staff for former US Congressman Dick Nichols and former Kansas Governor Mike Hayden. Additionally, his experience includes tenures with the American Society of Clinical Pathologists and with the Heart Rhythm Society where he established a Washington, DC based government affairs office. Prior to joining NRHA, he served as a federal lobbyist for VHA Inc.
Mr. Morgan’s health policy articles have been published in: The American Journal of Clinical Medicine, The Journal of Rural Health, The Journal of Cardiovascular Management, The Journal of Pacing and Clinical Electrophysiology, Cardiac Electrophysiology Review, and in Laboratory Medicine. He also served as a co-author for the publication, “Policy & Politics in Nursing and Health Care,” and for the publication, “Rural Populations and Health.”
He holds a bachelor's degree in journalism from University of Kansas, and a master's degree in public administration from George Mason University. In 2013, he was selected by readers of Modern Healthcare Magazine as being among the top 100 most influential people in healthcare.