Understanding Rural Health Disparities and How To Combat Them

Access to health care is a cornerstone of good health, yet millions of rural Americans face significant barriers that limit their ability to receive timely and quality care.

“People who live in rural areas tend to be older and sicker than people living in urban areas,” reports the Centers for Disease Control and Prevention (CDC). The consequences of these barriers ripple across communities, leading to poorer health outcomes and preventable hardships in rural communities.

A 2024 paper in the Journal of Appalachian Health written by Sydeena E. Isaacs, Jennifer Schroeder Tyson, Ashley Parks, and Danielle Adams of Appalachian State University breaks down the disparities in health care access in rural Appalachia: “The supply of primary care and mental health providers, specialty physicians, and dentists is significantly lower compared to national averages (20%, 35%, 28%, and 26%, respectively); rural counties within the region are most impacted by these disparities.”

The authors go on to explain that “due to this lack of access, people may often go long periods of time without visiting a healthcare professional for checkups because they do not feel ill. This allows diseases without highly uncomfortable initial symptoms (e.g., hypertension and diabetes) to worsen.”

Understanding these challenges is the first step in bridging the gap, and targeted strategies are key to improving health equity in rural areas. Learn how the Bachelor of Science (BS) in Health Care Management at App State Online can prepare professionals to understand rural health disparities and how to develop, manage, and fund programs to address them.

The Importance of Health Care Access in Rural Areas

According to the CDC, access to health care improves disease prevention, enables early detection and treatment of illnesses, enhances quality of life, and reduces preventable deaths. The benefits extend beyond individuals to entire communities, fostering longer life expectancy and healthier populations.

Health care access is more than the mere availability of services – it also includes the ability for individuals to utilize these services in a timely and confidential manner.

Barriers to Health Care Access in Rural Communities

Rural residents face unique challenges that hinder their access to care despite there being critical needs.

Geographical and Transportation Barriers

The 2024 paper in the Journal of Appalachian Health, mentioned above, explains that one of the most significant challenges for care access in rural areas is transportation and location: “The lack of healthcare facilities in the area, combined with its isolation, means it can take more than an hour for some families to reach a hospital.” A lack of public transportation options compounds this issue, leaving those without reliable personal transportation struggling to attend appointments.

Workforce Shortages

Many rural areas face severe shortages of health care providers, including primary care physicians, dentists and behavioral health specialists.

According to the Rural Health Information Hub, a resource supported by the U.S. Health Resources and Services Administration (HRSA) and the U.S. Department of Health and Human Services (HHS), 66.33% of Primary Care Health Professional Shortage Areas (HPSAs) were in rural areas as of September 2024. This shortage not only limits access but also overwhelms existing providers, leading to long wait times for patients and burnout for health care workers.

Health Care Communication Challenges

Lack of critical health communication to rural residents is a pervasive issue. In many rural communities, health services are only inconsistently available. Frequent changes in the types of services offered and the availability of services, sometimes due to high staff turnover, make it difficult for individuals to know where and how to seek health care.

In addition, the Rural Health Information Hub reports that rural residents may have limited health literacy, making it difficult to navigate the health care system. For non-native English speakers, language barriers can further hinder communication and trust between patients and providers.

In tight-knit rural communities, privacy concerns and stigma may deter individuals from seeking care, particularly for mental health or substance use issues. Anonymity can be nearly impossible in smaller rural communities when accessing local health clinics requires in-person visits. As one participant from a rural town put it in a 2024 study published in the International Journal of Environmental Research and Public Health: “You don’t want to park your car in front … people know what you drive.”

The fear of judgment or confidentiality breaches can prevent individuals in rural communities from getting the help they need.

Financial Barriers

Even when care is available in rural spaces, financial obstacles often prevent rural residents from accessing it. Limited health insurance coverage, high out-of-pocket costs, and the absence of affordable insurance plans are common financial barriers.

Individuals and families living in rural poverty may not have the opportunity to take time off or to afford the transportation costs associated with traveling long distances to access medical care. For this reason, many rural residents living in poverty may delay or forgo much-needed medical care.

Disparities Among Specific Populations in Rural Areas

Certain populations in rural areas are disproportionately affected by these barriers:

Elderly residents: Older adults often face mobility issues and chronic health conditions that require consistent care, which can be challenging to access in rural settings.
Low-income families: Limited financial resources make health care costs prohibitive, particularly for uninsured or underinsured individuals.
Immigrants and people facing cultural barriers: Cultural, social and linguistic barriers may exacerbate rural health disparities, creating additional obstacles to accessing quality care.
Pregnant individuals: Rural areas frequently lack specialized services such as maternity services, further widening maternal health gaps.
Individuals suffering with mental health: Additionally, mental health support for common mental illnesses and addiction is often lacking in rural communities.

Rural communities must develop strategies to improve health care access and equity.

Strategies To Improve Rural Health Care Access

Addressing rural health disparities requires a multifaceted approach that tackles financial, logistical and systemic barriers.

Improving Rural Transportation Options

Community-supported transportation initiatives and partnerships with local governments can provide affordable transit solutions for rural residents. For example, volunteer driver programs or subsidized ride-sharing services can help individuals reach appointments.

Leveraging Technology and Telehealth

Telehealth enables patients to access routine checkups, mental health counseling and specialist consultations from the comfort of their homes, reducing travel time and costs. App State faculty who work in the telehealth space note that the onset of the COVID-19 pandemic changed the health policy landscape and funding mechanisms to allow for more providers to provide and be compensated appropriately for telehealth services. However, this solution may also challenge health care providers to adapt their models of care and integrate technology and added equipment and cost to continue to provide services.

The use of telehealth programs may enable individuals living in rural areas to access medical support remotely – provided that they have a stable internet connection. So, expanding broadband internet access in rural areas is essential to supporting telehealth services. Health care administrators and public policy professionals play a pivotal role in aligning the funding and resources, both at a community and at an organizational level, to effectively leverage telehealth as a solution for rural individuals.

Expanding the Rural Health Care Workforce

More health care workers are needed in rural communities. This gap includes not only doctors, nurses and other health care providers, but health care managers and executives whose expertise in the management of health care programs, clinics and organizations enables patients to access health services in rural areas.

To address workforce shortages, loan forgiveness programs and scholarships for health care professionals willing to work in rural areas can help. Telehealth programs can also supplement local services by connecting patients with specialists.

Promoting Health Literacy and Cultural Competency

Educational programs tailored to rural populations can improve health literacy and empower individuals to take charge of their health. Training health care providers in cultural competence and effective communication can foster trust and understanding in rural communities.

Addressing Financial Barriers

Financial barriers in rural communities require a combination of health care and public health policy reforms to address rural poverty at its roots.

For example, expanding Medicaid programs and offering subsidies for insurance plans can ease the financial burden on rural residents. Additionally, increasing financial incentives for providers to practice in rural areas can attract much-needed health care professionals.

Support Rural Health With a Degree in Health Care Management

Rural health disparities are significant, but they are not insurmountable. Addressing barriers such as workforce shortages, financial constraints and transportation challenges can create a more equitable health care system. Investing in technology, education and infrastructure is crucial to improving health outcomes for rural communities. Collaboration between policymakers, health care providers, health care managers and administrators, and local communities is essential to driving meaningful change.

Ready to start your career in supporting rural health? Discover how a Bachelor of Science (BS) in Health Care Management from App State Online prepares professionals with the skills and experience they need to address rural health disparities. Graduates enter the workforce with a valuable foundation in health care leadership, ethics, informatics and financial management.

Take the next step today. Prepare for your new career with App State Online.

Recommended Readings:

4 Health Care Administration Careers for Graduates To Consider

6 Essential Health Care Administration Skills

What Is the Role of a Human Resources Manager?

Sources:

Centers for Disease Control and Prevention, About Rural Health

Centers for Disease Control and Prevention, Rural Public Health

Journal of Appalachian Health, “Check with the Intended Audience First! Content Validation as a Check with the Intended Audience First! Content Validation as a Method for Inclusive Research for Primary Care Engagement in Rural Appalachia”

National Association of County and City Health Officials, A Guide to Building a Climate-Ready Workforce

National Consortium of Telehealth Resource Centers, Telehealth Resources

Rural Health Information Hub, Barriers To Addressing Health Literacy in Rural Communities