Rural Health Disparities

Module 3: Rural Health Disparities

This module introduces some of the health disparities that are a reality for many rural dwellers.

Approaches nurses can utilize to mitigate the impact of some disparities will be addressed.

Module Objectives:

1) Appraise barriers to optimal health care that exist in rural areas.

2) Analyze factors that impact access to care in rural areas.

3) Explore consequences of limited access to healthcare.

4) Explore ways nurses can promote health in areas of limited health care access.

 

Assigned readings:

Bushy, A. (2013). Health Disparities in Rural Populations Across the Lifespan. In C.A. Winters (Ed.), Rural

nursing: Concepts, theory, and practice (pp.225 – 239). Springer.

http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sw

w&AN=547705&scope=site

American Nurses Association (2015). Code of ethics for nurses: With interpretive statements. Silver

Spring, MD: ANA. (choose portions that will be valuable in your synthesis and application post)

https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk

&AN=1021757&scope=site

COVID – 19 and Rural Health Care. (2020). Online Journal of Rural Nursing & Health Care, 20(1),

15. https://doi.org/10.14574/ojrnhc.v20i1.626. Available at

https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=ccm&AN=143781889&scope=site

Erwin, C., Aultman, J., Harter, T., Illes, J., & Kogan, R. C. J. (2020). Rural and Remote

Communities: Unique Ethical Issues in the COVID-19 Pandemic. American Journal of Bioethics,

20(7), 117120. https://doi.org/10.1080/15265161.2020.1764139.

https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=ccm&AN=144785432&scope=site

Shreffler-Grant, J.M., Nicols, E., Weinert, C, & Ide, B. (2013). Complementary Therapy and Health

Literacy in Rural Dwellers. In C.A. Winters (Ed.), Rural nursing: Concepts, theory, and practice

(pp.205- 214). Springer.

http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sw

w&AN=547705&scope=site

 

Be sure to take adequate time to peruse Rural Health Information (RHI) Hub and Center for Disease

Control (CDC) sites as well as other information linked into this module

 

Key points

Communities in rural areas are impacted by policies developed at the national level.

Competition between rural and urban areas in the domain of healthcare occurs increasingly as

resources become scarcer.

Healthcare policies impact rural and urban areas in unique ways.

A variety of social determinants may impact the health of individuals and families.

Although health disparities occur in all settings, there are a number that are particularly

noteworthy in rural areas.

Poverty often compounds other risks and vulnerabilities.

A high proportion rural residents are among the working poor and uninsured. Low income

correlates with lower educational levels, poorer nutrition, fewer preventative health care

practices, increased risk of trauma, developmental delays, inadequate immunization, and

increased chronic illness.

Rural people are often older. Many elderly adults have a low fixed income, relying primarily on

social security benefits. They may have difficulty accessing additional benefits

Graded Assignment:

You will complete your next synthesis and application assignment. Synthesis and Application

assignments have two separate components. Please see the information in the Synthesis and

Application Assignment folder for a video and more detailed direction. Refer to the grading rubric

(Appendix B in your syllabus or at the end of this document) for how points can be earned. Carefully

note the criteria for a professional nursing journal as found in the course syllabus (p. 9).

Part 1: Choose one of the situations /topics below. You may need to refer back to information from

prior assigned readings in addition to the readings assigned for this module. Respond to the situation

you choose in the discussion forum adhering to the grading rubric in Appendix B. Note thatall partsof

the discussion question/topic must be addressed to earn full points. You can earn up to 15 points for

your initial post.

Part 2: There is an opportunity to review what your peers have posted and build on their knowledge and

insights by the date included on the course schedule.You will post a substantive addition to one of your

peers’ post. Your substantive addition must address the topic/situationother than the topic/ situation

addressed in your original synthesisand application post. You can earn up to 10 points a substantive

addition that meets rubric criteria.

As you search for articles the first weeks of this course, two journals that may be especially helpful are

theOnline Journal of Rural Nursingand Health Careand theJournal of Rural Health. Both are readily

accessible via the SMSU library. There are many other articles and journals that will be helpful as well.

Topic One

1. Examine three barriers that may impact access to health care (not including lack of services) that may

be especially prevalent in rural areas in the United States. Note: A professional examination

 

regarding this question should include at least three well thought out and professionally written

sentences examining each of the three barriers you choose.

2. What are some interventions nurses can implement to mitigate the impact of these barriers?

3. Compare and contrast potential barriers to access to care in rural versus urban areas.

Topic Two

1. How might limited access to health care impact the use of complementary and alternative therapies?

2. Discuss the long-term consequences of limited access to health care services. Include how limited

access impacts individuals, families, and the health care system.

3. Briefly discuss two provisions from the Code of Ethics with Interpretive Statements that are relevant

when considering health care disparities.

 

Appendix B: Synthesis and Application Assignment rubric

Remember that integrating your own thoughts with evidence from the literature is an effective to

demonstrate synthesis and critical analysis. Sometimes a few short direct quotes add value to your

work. But remember that long quotes generally serve to share someone else’s thoughts, rather than

your analysis.

Please refer to the Synthesis and Application folder for a more detail and guidance.

 

Primary post

 

Criterion Excellent Competent Not satisfactory

Complete All questions from one chosen

scenario/topic addressed in a

clear, focused manner. All

responses demonstrate critical

analysis (3 points)

 

Not all questions

addressed OR responses

not clear and focused

(2 points)

 

Not all

required

questions

addressed. (0

points)

 

Demonstrates

synthesis of

assigned

readings

 

Post demonstrates that the

assigned content was

appropriately reviewed,

understood, and synthesized.

Minimal direct quotations.

(points) (6 points)

 

Demonstrates limited

familiarity and

synthesis of assigned

content. (3 points)

 

Not all questions

addressed.

Responses do not

demonstrate

synthesis of

assigned readings

(0 points)

 

Evidence based At least two professional

resources support post.

Resources must be integrated,

 

Supported by fewer than

two citation/reference

pairs. Or provides

 

Provides no

scholarly reference

to support

 

cited, and referenced per APA

style. See criteria for

professional references on p. 9

of syllabus. Rare APA style

errors. (3 pts)

 

evidence-based, scholarly

references using incorrect

APA format. Or provides

non-scholarly references

with correct APA format

in-text. (1.5 points)

 

position/ideas in

postings/discussion

and /or uses no

APA format

(0 points)

 

Writing quality Punctuation, spelling, spacing,

capitalization, and writing

mechanics errors are rare.

 

Fewer than six total

writing mechanics

 

Six or more writing

mechanics errors;

run-on sentences.

 

Writing is clear, succinct,

focused, organized, Easy to

understand main ideas. (2

points)

 

Writing is focused and

organized. (1 point)

 

Writing lacks

organization or

focus (0 points)

 

Posted Posted in both the discussion

forum and the assignment box.

(1 point)

 

Not posted in both the

discussion forum and the

assignment box (0 points)

 

Not posted

as directed.

(0 points)

Substantive addition – addition must address the topic/situationother than the topic/ situation

addressed in your original synthesisand application post to earn any points.

Criterion Excellent Competent Not satisfactory

Addition

relevant

and

valuable to

nursing

practice

 

Substantive addition

demonstrates thorough review

of post. Adds at least one new

perspective that would be

relevant and valuable in nursing

practice situations. (3 points)

 

Addition accurate,

but application to

nursing practice

limited. (1.5 points)

 

Relevance to

nursing practice

not included.

(0 points)

 

Demonstrates

critical analysis

 

Offered a critical analysis of an

existing posted. Demonstrates

that the assigned content was

appropriately reviewed,

understood, and synthesized.

(3 points)

 

Addition demonstrates

limited synthesis of

assigned content

related to the

situation/topic. Agreed

or disagreed, but did

not provide

justification. (1.5

points)

 

Response not

applicable to the

situation/topic.

(0 points)

 

Supported by

evidence

 

At least one professional

resource supports post.

Resources must be integrated,

cited, and referenced per APA

style. See criteria for

professional references on p. 9

of syllabus. Rare APA style

errors. (3 pts)

 

Supported by at least one

citation/reference pair.

Provides evidence-based,

scholarly reference using

incorrect APA format Or

provides non-scholarly

references with fewer

than four APA format

errors. (1.5 points)

 

Provides no

scholarly reference

to support

position/ideas in

postings/discussion

and /or uses no

APA format (0

points)

 

writing quality Punctuation, spelling, spacing,

capitalization and writing

mechanics errors are rare.

Writing is clear, succinct,

focused, organized, Easy to

understand main ideas. (1

point)

 

Fewer than 6 total writing

mechanics

Writing is focused and

organized. (0.5 points)

 

Six or more writing

mechanics errors;

run-on sentences.

Writing lacks

organization or

focus (0 points)

Rural Health Disparities

Introduction

The rural healthcare system is often overlooked in discussions about disparities. The presence of these disparities, however, must be addressed by professionals and policy makers working together to improve the quality of care provided to rural residents. In this article, I will discuss some of the factors that contribute to the disparity between urban and rural health care systems.

Disparities in rural health care can be measured by both access and quality.

Access to healthcare is often influenced by socio-economic factors. For example, the availability of health insurance and transportation can influence whether a person has access to appropriate medical care. Additional factors include the availability of mental health services, which may be lacking in rural areas.

Disparities in rural health care can be measured by both access and quality. Access includes the number of people who receive treatment for an illness or injury within a given time period; quality includes whether each patient receives good-quality care during this time period (American College of Physicians).

Rural people experience lower life expectancy than urbanites.

Life expectancy is lower in rural areas than urban ones. This is due to a number of factors, including less access to healthcare and higher rates of suicide.

Rural communities are also more vulnerable to the effects of climate change because they have less ability to adapt when weather changes occur rapidly or unpredictably.

Access to healthcare is often influenced by socio-economic factors.

Access to healthcare is often influenced by socio-economic factors. Rural people, who tend to be poorer than urban residents, are more likely to have health insurance. They also may not be able to afford the cost of medical care. The uninsured rate in rural areas is higher than that of urban areas and can vary significantly between counties within a state as well as across states (1).

Rural communities also have higher rates of depression, PTSD and substance abuse among young adults.

Rural communities also have higher rates of depression, PTSD and substance abuse among young adults.

Depression is the most common mental health issue in America. According to the National Alliance on Mental Illness, nearly 15 million people suffer from depression every year–and that number can be even higher if you’re living in rural areas where there are fewer resources available to help you manage your symptoms.

PTSD is another common condition among military veterans who have witnessed trauma during wartime or through criminal activity (such as domestic violence). And while it’s widely accepted that traumatic events lead to long-term issues for those who experience them, it’s not uncommon for someone with PTSD symptoms to develop them years after their trauma occurred; this may be because some individuals don’t realize they’ve experienced a traumatic event until later in life when they start having flashbacks or other emotional reactions related back then when something terrible happened.”

Rural communities are more dependent on public transportation than urban areas.

There are a number of factors that make rural communities more dependent on public transportation than urban ones. These include lower rates of car ownership, higher use of public transit, walking and biking, using taxis or ride shares, and motorized transport.

Rural communities have higher rates of poverty than cities do.

Poverty is a major issue in rural areas. Rural poverty rates are higher than those in urban areas, especially for those living below the poverty line. Poverty can have negative effects on the economy, health and environment of your community.

The reason for this disparity between urban and rural communities has less to do with demographics than you might think: it’s not necessarily about differences in income or education levels–it’s about access to resources like housing, food security (the ability to buy what you need) and transportation infrastructure (such as roads).

There are specific disparities within rural communities that must be addressed by professionals and policy makers working together.

Rural communities have higher rates of depression, PTSD and substance abuse than urban areas. They also have lower life expectancy than urbanites. The U.S Department of Agriculture found that rural Americans live about four years less than their urban counterparts–a significant difference in terms of quality of life and health outcomes when it comes to mental health care.

Access to healthcare is often influenced by socio-economic factors like where you live or who you know (for example, if someone has more money they can afford better housing). Rural residents tend to lack access because they don’t have good transportation options like public transportation or cars so they tend not to leave their homes as often which means they may not receive timely medical treatment if needed.[1][2][3]

Conclusion

Rural communities have been identified as having lower life expectancy, higher rates of depression and substance abuse among young adults, and lower rates of access to healthcare than urban areas. These disparities can be measured by both access and quality.