When comparing rural vs. urban healthcare, numerous disparities exist. Healthcare providers, including nurses, are continually working to improve access to rural health services and deliver improved patient outcomes. By being aware of the leading rural health challenges, nurses and other members of the healthcare team can work to provide patients in rural areas with more targeted care.
Understanding Rural Healthcare
According to the Centers for Disease Control and Prevention (CDC), about 20% of United States residents live in rural communities. Despite the large number of people who reside in these areas, a disproportionate number of health complications occur in rural regions. People living in rural areas are at a higher risk of death than those who live in urban areas, because they are located farther away from specialized healthcare treatment services — as well as exposed to environmental factors that some urban areas are not.
Definition and Demographics
The U.S. Department of Agriculture Economic Research Service defines rural areas as those that include open country land and comprise fewer than 2,000 housing units and fewer than 5,000 residents. Essentially, rural areas have a lower population density combined with greater age distribution — which can present barriers to providing personalized and specialized healthcare services to those who live there. The Rural Health Information Hub also notes that, in general, rural populations have a lower socioeconomic status than more densely populated urban areas, which may influence the specific healthcare needs of the people who live in rural areas.
Unique Characteristics of Rural Healthcare
Rural health disparities can be attributed to a variety of factors. According to the National Rural Health Association (HRHA), several characteristics that set rural healthcare apart from urban settings include:
- There are fewer healthcare workers in rural areas, making it more difficult for people in rural regions to access rural primary care and specialized healthcare services.
- Rural populations tend to have a lower income level, which can present challenges to accessing healthcare resources or finding transportation to travel to healthcare treatment facilities.
- Rural populations tend to have a higher percentage of uninsured patients, which can exacerbate accessibility issues.
Challenges in Rural Healthcare
Before healthcare providers can begin developing programs and creating resources for rural populations, they must recognize the challenges that currently permeate rural healthcare. Understanding these ongoing challenges can help healthcare providers shape their programs and create targeted strategies designed to improve health outcomes in these communities.
According to the NRHA, the following points encompass some of the most pressing challenges in rural healthcare.
Limited Access to Care
The fact of the matter is, people who live in rural areas have limited access to healthcare, specifically specialized healthcare treatment services. The NRHA notes that there are about 31 physicians for every 10,000 people in urban areas, in comparison to only 13 physicians per 10,000 people in rural areas. Family physicians provide 42% of all healthcare treatment services in rural areas — underscoring the limited access to personalized and specialized care that is available in rural communities. This limited access can hinder timely medical intervention and result in poor outcomes for patients who need high-level care.
Scarcity of Specialized Services
The scarcity of specialized services has a direct impact on patient outcomes. According to the American Journal of Managed Care, the lack of specialized services in rural communities can lead to poor short-term and long-term outcomes, with these specialized services being the most in demand in such areas:
- Rural primary care
- Mental health treatment services
- Maternal health
- Dental care
- Trauma care
Workforce Shortages and Resource Constraints
One of the most notable healthcare challenges facing rural communities is that there are simply not enough healthcare workers in rural areas. As a result, patients must travel greater distances to reach healthcare providers, and they may struggle to make an appointment with a qualified healthcare provider. The ongoing workforce shortage and limited resources in rural areas substantially impact healthcare access in these communities.
Recruitment and Retention Issues
It can be difficult for healthcare facilities to recruit and retain the most qualified healthcare providers. According to the Joint Economic Committee, ongoing recruitment and retention issues for healthcare providers in rural settings include:
- Rural healthcare treatment centers offer lower salaries than healthcare facilities in urban areas.
- Rural areas often do not have the same number of opportunities for skilled workers, leaving some medical professionals to feel like rural communities are not the right fit for their entire family.
- Many rural healthcare providers are medical professionals who grew up in the local area, but access to education limits the number of people in rural communities who go on to pursue a medical education.
Economic and Social Barriers
Many modern healthcare providers want to work in state-of-the-art facilities where they can utilize advanced medical technology to improve patient outcomes — and the outdated facilities in rural areas can limit their ability to offer effective healthcare delivery. Considerable economic and social barriers exist in rural areas, such as:
- Lower income levels – The NRHA notes that the average income per capita in rural areas is about $45,000, whereas it’s closer to $53,000 in urban areas.
- Higher poverty rates – According to the NRHA, about 25% of children in rural areas live in poverty.
- Limited insurance coverage – Rural residents are more likely to be uninsured, which can make it impossible for them to receive timely, high-quality healthcare services.
RNs Role in Rural Healthcare
First Point of Contact and Comprehensive Assessment:
In rural settings, RNs frequently function as the initial healthcare provider encountered by patients. Due to the scarcity of physicians and specialists, RNs must be adept at recognizing subtle symptoms, differentiating between acute and chronic conditions, and initiating appropriate interventions.
Communication and Collaboration:
Effective communication is paramount in rural healthcare. RNs act as liaisons between patients, families, and other healthcare providers, often spanning vast geographical distances. RNs must communicate complex medical information in a clear manner to create trust with the patient.
Health Education and Promotion:
Given the limited access to care in rural areas, RNs are often the main source of health education. By educating individuals, RNs contribute to improving the overall health and well-being of the community.
Home Health Visits and Continuity of Care:
Home health visits are a cornerstone of rural nursing practice. RNs provide care to patients in their homes, particularly those with chronic illnesses, disabilities, or limited mobility. Home health visits also facilitate continuity of care, ensuring that patients receive consistent support and monitoring between clinic visits.
Community-Based Approaches
Community health initiatives are being leveraged more often in rural communities because they are developed in cooperation with local community officials and are able to address the unique cultural values, traditions and beliefs of the local population. These initiatives are designed to empower local populations while respecting their values and belief systems. Healthcare providers may also work with local organizations in rural communities to improve access to healthcare treatment services and educate residents about the steps they can take to protect their physical and mental health.
Telehealth and Technological Integration:
RNs are at the forefront of telehealth implementation, providing remote patient monitoring, conducting virtual consultations, and delivering health education through digital platforms. Telehealth not only increases access to care but also improves patient engagement and reduces the need for costly and time-consuming travel.
Mobile Health Clinics
According to research published in the International Journal for Equity in Health, mobile health clinics are customized motor vehicles that travel to communities around the country in order to provide specialized and specific healthcare treatment services. The treatment services available may vary based on the mobile health clinic — and currently, more than 2,000 mobile health clinics are working to improve health equity and access in rural communities.
Policy and Funding Initiatives
According to the Association of State and Territorial Health Officials, policymakers are working tirelessly to create proposed policy changes aimed at boosting rural healthcare resources and improving infrastructure. Examples of the types of policies that legislators and health officials are working on include:
- Creating policies to recognize a new type of hospital.
- Exploring alternative sources for healthcare treatment services.
- Providing targeted funding aimed at improving healthcare facilities and infrastructure in rural communities.
Federal and State Support Programs
In some cases, rural communities can receive federal or state support in order to improve access to healthcare treatment services as well as enhance healthcare infrastructure in their areas. There may be grants, subsidies and other funding mechanisms available that can help strengthen rural health systems and ensure that residents in rural areas have access to high-quality, specialized healthcare treatment services. Ongoing support and funding will be required to address the challenges associated with rural healthcare delivery and to reduce the health disparities among rural populations.
Explore the Differences Between Rural vs. Urban Healthcare at Nevada State University
Improving access to high-quality rural health services is crucial to bridging the health equity gap that persists today. At Nevada State University, our RN to BSN online program offers a comprehensive look at the modern healthcare system and provides nurses with an opportunity to build upon their existing foundation and develop advanced nursing skills. Throughout this degree program, students can explore the strategies and techniques required to improve rural health outcomes.
Request more information about our nursing programs to begin furthering your education today.