New Report on Improving Rural Health — What You Need to Know

A report from the County Health Rankings & Roadmaps program, a partnership between the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, details ideas and strategies for improving rural healthcare in the United States. The report looks at why people get sick in rural communities and what can be done to keep them healthy.

To understand why some counties are healthier than others, the report begins by examining the contributing factors to a person’s mental and physical health.

Here’s what the report found:

Health behaviors

Tobacco use — This is the “leading cause of preventable death” in the US, affecting not only the user, but also the people around those who use tobacco.

Diet and exercise — A person’s risk for obesity and being overweight is determined by genetics and by access and a commitment to choosing healthy food and engaging in opportunities for physical activity.

Alcohol — Excessive alcohol use is harmful to one’s health, and the abuse of prescription medication and illegal drugs has negative implications for a person’s economic, physical, and social health.

Sexual activity — Risky sexual behavior can spread sexually transmitted diseases and result in unplanned pregnancies, both of which can have long-term implications for one’s health and well-being.

Clinical Care

Access to care — Access to affordable, quality healthcare and health insurance is key to an individual’s emotional and physical health.

Quality of care — A person’s health is likely to improve if he or she can access quality care in a timely way.

Social and economic factors

Education — People who are educated tend to live “longer, healthier lives.” Moreover, their children tend to be more likely to thrive than those born to parents with less education.

Employment and income — People with better jobs and more income have increased access to better food, childcare, and housing, which can lead to improved health.

Family and social support — People who are less isolated and are more connected to others tend to be healthier.

Community safety — Unintentional injuries such as falls, traffic crashes, and ingesting poison are the fourth-leading cause of death in the United States and can directly impact people’s health and quality of life.

Physical environment

Air and water quality — People need clean air and water for good health. Additionally, polluted air and water can be especially harmful to people who are young, elderly, or suffer from chronic health issues.

Housing and transit — People’s choices about where they live and their form of transportation affect their wellbeing.

According to the report, community leaders, in partnership with stakeholders, should consider the specific health issues in their communities and strategies to address them, with a logical awareness that there is no single strategy to benefit all communities.

Rural communities tend to struggle the most with issues such as child poverty, unemployment, injury deaths, and access to quality health care, and addressing any of those issues likely will have a positive impact on residents’ quality of life and health. The following are some strategies the report recommends that rural communities implement to improve health across a range of fronts:

* Establish a rural transportation system, providing public funding for programs such as scheduled van and bus routes, volunteer ridesharing, and on-call transportation.

* Provide flexible schedules for employees that allow them to work shifts, flexible time, and compressed work weeks.

* Incorporate speed cameras, radar, and other devices to enforce speed limits and make roads safer.

* Create and implement seat-belt enforcement programs with extra patrols and officers to make sure that people follow seat-belt laws.

* Use scholarships and loans with service requirements or forgiveness programs to encourage more students in health fields to practice in rural areas.

* Implement telemedicine programs to provide remote diagnosis, consultation, and treatment services for patients in remote areas who have limited access to care and need to be monitored frequently.

* Employ community health workers to do home visits and manage cases for people in rural communities who have health risks.

* Provide more support for nonprofit, federally funded healthcare organizations that work with patients have no insurance or inadequate insurance.

* Expand farmers markets where vendors can sell fresh fruits and vegetables, prepared foods, meat, and dairy foods.

* Work with food banks to provide clients with nutrition information and more options for healthy eating though activities such as recipe tastings and cooking demonstrations.

* Open access to physical activity by building new facilities or increasing existing facilities to encourage more people to participate.

* Provide more support for nutritious breakfast programs at schools through cafeteria menus and grab-and-go carts in hallways and classrooms.

* Promote programs that encourage children to increase physical activity rather than watch TV or engage in other screen media.

Finally, the report recommends that communities should consider strategies for improvement by assessing if the strategy benefits their target population (such as seniors or people with low incomes), whether the strategy’s proven outcomes are similar to the community’s goals for change, and whether it’s viable to implement the strategy or whether it needs to be revised for their specific community.