Skip to main content

Currently Skimming:

2 Potential Challenges and Opportunities in Rural Communities
Pages 5-18

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 5...
... Morris explained that the payer mix for health care tends to be different than what is found in urban areas. In rural communities, Medicare, Medicaid, and the Children's Health Insurance Program are the dominant payers.
From page 6...
... In the western United States, weather can be a limiting factor in a way that it is not in other parts of the country. The mix of health care providers varies, although many areas suffer from provider shortages.
From page 7...
... This is a "real challenge," said Morris, for addressing behavioral health. Given the economic challenge of providing care in rural communities, federal legislation provides special protections to the hospital and clinical infrastructure in these areas.
From page 8...
... Solutions to problems that work in urban areas may not work in rural areas. For example, when Medicare started paying for diabetes self-education management, many rural communities could not meet the requirements for trained personnel needed for reimbursement.
From page 9...
... The office invests about $60 million per year in community-based funding that is limited to rural communities so they do not have to compete with metropolitan areas. Its programs include public health screening, care coordination, defibrillator and opioid-reversal programs, grants focused on performance and quality improvement for small rural hospitals, state offices of rural health, telehealth network grants and resource centers, and licensure and portability efforts.
From page 10...
... OVERLAPPING INEQUITIES Inequities based on race and ethnicity overlap with and intensify inequities based on geography, observed Michael Meit, co-director of the NORC Walsh Center for Rural Health Analysis and senior fellow in NORC at The University of Chicago Public Health Research Department, in the second keynote address of the workshop. "When you overlay those two, you have a dual disparity.
From page 11...
... Neighborhood and built environment -- access to healthy foods, quality of housing, crime and violence, environmental conditions Across most of these social determinants of health, rural populations do not fare as well as urban populations. The median household income
From page 12...
... The counties are largely rural, including counties in Appalachia, the Mississippi Delta, the "Stroke Belt" in the southeastern United States, and along the U.S.–Mexico border. These regions are also the areas with the highest rural minority populations, with African Americans in the South and Southeast, Hispanics FIGURE 2-3  Persistent poverty counties have had poverty rates of at least 20 percent in the U.S.
From page 13...
... The study examined mortality data for the 10 leading causes of death by age bracket (for the 25 to 64 years age range, this included cerebrovascular diseases, diabetes, heart disease, homicide, liver diseases, lower respiratory diseases, malignant neoplasms, septicemia, suicide, and unintentional injuries)
From page 14...
... Toolkits are housed in the Community Health Gateway, part of the Rural Health Information Hub, which Meit referred to as "a one-stop shop for everything rural." Meit also highlighted new work being conducted by the NORC Walsh Center that is funded by the Robert Wood Johnson Foundation. This body of work seeks to identify strengths and opportunities that can accelerate and improve health and well-being in rural communities; identify factors (and partners)
From page 15...
... He also pointed out, however, that insurance regulation tends to work against rural communities. Risk needs to be pooled among larger populations, he said, to attract insurers, "and not just for the Affordable Care marketplaces but for every form of insurance." In response to a question about the training of EMS personnel, Morris observed that they are volunteers, which raises questions about the requirements they can be asked to meet.
From page 16...
... Overall, however, the public health infrastructure "struggles more in our rural communities," Meit continued, adding "We have good data to demonstrate that." Furthermore, funding seems to be getting even tighter for small rural health departments. Meit asked: What is the implication of not having boots on the ground in our com munities to do disease surveillance, to track infectious disease, to do epidemiological investigations to control outbreaks, to do health educa tion, all of the core work of public health?
From page 17...
... In a discussion about the dissemination and scaling up of successful models, Morris pointed out that it is often easier to ramp up a model that has proven successful in a rural area than to translate an evidence-based model from an urban area to a rural one, given the frequent need to discard parts of the model for use in a rural area. Rural communities can be better places to test models than urban communities because fewer things are going on that can potentially influence outcomes.
From page 18...
... 18 ACHIEVING RURAL HEALTH EQUITY AND WELL-BEING tation in shaping rural health care. "In every rural meeting we have held, the two issues that come out at the top in terms of infrastructure capacities are transportation and broadband," said Meit.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.