Rural
Communities
Population Health NURS 4330
Dr. Mager
Learning Objectives
Rural America
More diverse and aging populations
in Rural areas
One in five individuals in rural areas
are > 55 years old
One fifth of the population in rural
America is of an ethnic or racial
minority such as Asian and Pacific
Islanders, Black Americans,
American Indians and Hispanics
Healthcare cannot be generalized to
any specific rural community
Rural Considerations
Nearly 57 million people live in rural
communities nationwide
Majority of Health Professional Shortage Areas
(HPSAs) exist in rural areas
The majority (nearly 85%) of home care
agencies reside in metropolitan areas
Higher chronic disease rates & higher numbers
of preventable hospitalizations than urban areas
Trends regarding Rural community dwellers:
They tend to:
Be older
Have lower income and higher Medicaid utilization
Be smokers
Have higher body weights than urban dwellers
Have lower life expectancy
Limited access to care + health risks and
resultant trends =
poorer health outcomes, increased
hospitalizations and health care costs in rural
areas
Access to Care:
Challenges in Rural
America
Care access can be related to a lack of available
resources such as insufficient numbers of
providers or facilities.
The Health Resources and Services
Administration can deem regions to be:
Medically Underserved Areas (MUAs)
Areas or populations that have insufficient primary
care providers, have high infant mortality rates,
high poverty levels, or an abundance of elderly
people
Health Professional Shortage Areas
(HPSAs)
Occurs when there is a shortage of medical, dental
or mental health providers either geographically
or for a given population of people such as low-
income populations, or where there is a lack of
facilities to provide care
Solving the Rural Health
Care Shortage (2 min)
Note: to watch this imbedded video directly
from the power point (PP) slides, the PP must be
in “slide show” mode. Otherwise, you can go to
the “video clips” folder in each Bb module to
watch from there.
https://www.youtube.com/watch?v=R6BdeSky-
Lc
Telehealth
Telehealth is the delivery of health care through
telecommunication.
Helps facilitate communication and improve
access to care.
Advantages of telehealth:
aid in illness prevention and health promotion
contribute to curative health care through the use
of various technologies.
Through cardiac implantable electrical devices
(CIED) or through automated phones calls, nurse
calls, and/or patient reports of weight, BP, heart
rate, as well as monitoring symptoms to an
automated system.
Disadvantages of telehealth:
Cost
Issues with the patient connecting to the
equipment if Wi-Fi
Decreases human interaction
Rural Healthy People
2030
3 Main priorities for 2030
Health Care Access (#1 Priority)
Mental health
Addiction
The Nursing Role in
Rural Health Settings
Each rural community differs greatly, and as
such, nurses require significant knowledge of
each community’s profile, culture, and make up
in order to coordinate multi-faceted care.
Care coordination is a way to ensure that a
patient’s preferences and information are
shared across health care systems.
Nurse can use their knowledge of the
community and the resources available to find
and provide coordinated care.
Nursing Role:
Prevention Methods
Healthy Communities Initiative
Community-specific measures to promote good
health
Offers ways to support nurses and assists them in
having an integral role in developing interventions
to empower a community
This web-based resource connects health care
providers with on-line discussion boards to identify
what works and does not work in certain
communities
The Heart Beat Connections © Program
Identifies high risk individuals from an electronic
health record for cardiovascular disease
Once enrolled, patients receive additional
education, medical management, and a health
coach who contacts with them on a regular basis
Primary and secondary prevention
References
Population Health for Nurses: Improving
Community Outcomes (2020). Mager, D. &
Conelius, J. (Eds.). Springer Publishing: New
York. ISBN: 978-0-8261-4811-7
6: (Mager): Overview of Home Care and Rural
Settings
9: (Conelius): Care of Chronically Ill Populations in
Rural Settings: Heart Failure
Dept of Health and Human Services (2019).
Rural Health Information Hub
