Healthcare Disparities in the Rural Population

Healthcare Disparities in the Rural PopulationAmy HainesMichael KleinIntroductionThere 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. 2ObjectivesIdentify and discuss 3 factors that put rural communities at risk for health care disparitiesDiscuss 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 environmentAccording 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. 4Assessment cont.According to the U.S. Department of Health and Human Services (2015) rural communities tend to:Have higher poverty ratesHave higher percentages of elderlyHave 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 population5Assessment cont.Distance and lack of resources have strongly undermined quality health care in rural AmericaAccording to the National Rural Health Association (2015):People in rural communities tend to rely more heavily on government assistancePeople in rural communities are less likely to have employer-provided health insuranceRural health care providers and hospitals receive less compensation from MedicareRural areas experience a greater rate of accidents with slower response timesRural 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).6Root Cause AnalysisThere are many health concerns of rural communities, however these concerns may be traced back to decreased accessHealthy People 2010s 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.7ImplicationsRural 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?8ImplicationsRural 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 aidInitiating 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. 9RecommendationsIt is important for nurses and health care professionals to be able to identify what puts a person at risk for health disparitiesNurses 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

By identifying a problem health care professionals are then able to begin to address it in a systematic, informed way. This allows nurses to identify what factors can be modified, what factors should be modified, and how the modifications should be made. Nurses from urban areas especially should be sure to understand cultural norms as they may be different and contributing factors to poor health in rural areas. 10RecommendationsRural 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 areasNurses are able to raise funding for health care in rural areasNurses are able to provide community nursing to rural areas with focus on disease prevention, management of chronic diseases, and health promotionNurses can draw national attention to health disparities among the rural communitySome basic, but effective nursing interventions are listed. This would increase access to health care, education concerning health care, decrease health care costs, and help to eliminate health disparities.11RecommendationsAs 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

Follow up care should always be remembered in nursing. This gives insight to effective measures, what interventions should be modified (and how they should be modified), the need for continuation of interventions, and offers suggestions for similar cases. 12ConclusionRural 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 communitiesThis population represents a great need for intervention due to its size and the severity of health disparitiesNursing and health care have to opportunity to intervene and improve health care in rural America

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