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Population and Community Health Promotion Final Paper:

Rural Communities and Access to Healthcare

Madison McClafferty 

NUR330-602 

Professor Pini

Delaware Technical Community College 

July 23, 2023

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Health Promotion Final Paper: Rural Communities and Access to Healthcare

A population that community health nurses serve are those in the rural population. There

are over 50 million Americans who live in rural areas. Many rural Americans struggle to find

access to healthcare which can cause worsening health outcomes. (Why Healthcare is Harder to

Access in Rural America, 2023). Not only does rural communities have less accessible outpatient

healthcare, but many rural communities do not have an acute hospital of their own. Many of the

population in rural communities are older adults, many elderly, which then causes the need for

more medical care for this community. With the need for more medical attention, there is

difficulty in seeking the much-needed medical care for these patients since there is less

accessible healthcare in rural communities. Without accessible healthcare, there are higher

chances of death and sickness throughout these communities.

Review of the Data

With rural community residents having an increased amount of health conditions due to

their limited healthcare access, it does not help that when those issues become complicated, they

are less likely to obtain help. There have been studies conducted that showed that many rural

residents must travel for 20 miles or more just to receive in patient care which in emergency

cases can be life threatening (Why Healthcare is Harder to Access in Rural America, 2023).

Not only are there less hospitals in the area, the hospitals that are in rural areas are more

likely to close down and there has been 100 or more hospitals to shut down in rural areas

throughout a seven year period between 2013 and 2020 (Why Healthcare is Harder to Access in

Rural America, 2023). Many women lack reproductive care in rural areas and in the areas that

can have hospitals, there are no obstetrics or gynecology care in these hospitals. Along with
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these statistics, fifty percent or more rural Americans die from car crashes than urban residents

do, and with less access to healthcare causes more fatalities (About Rural Health Care, n.d.).

Disparities and Barriers

Major barriers to accessing healthcare for rural communities include having less access

due to their occupation. Many rural community residents are either farmers or work on their own

land, meaning that they do not have or can afford commercial health insurance. Rural community

residents are less likely to be uninsured for more of their lives than those in urban communities

and “their chances of being uninsured for an entire year are a third greater” than those in their

urban community counterparts (The Uninsured in Rural America, 2003).

Along with the difficulty of finding healthcare for patients who are residents of rural area,

there is also a shortage in healthcare professionals to bring primary care to these patients.

According to the Rural Health Information Hub, in late 2022 there was up to a 65.6% shortage of

healthcare professionals in rural towns (Rural Health Disparities, n.d). This shortage of

healthcare providers only adds to the disparities that rural residents go through. Rural area

residents have a higher risk of death and are usually sicker than those in other areas with more

access to healthcare. Some diseases that rural area patients tend to die of more than other areas

are cancer, strokes, and especially heart disease (About Rural Health, 2023).

As mentioned before, rural area residents have a higher risk of death due to their longer

distance needed to travel just to get access to emergency care. Even so, without their own

transportation to emergency care and acute care hospitals, there is a prolonged wait time for

emergency medical services (EMS) to reach rural area residents to aid in their healthcare needs.

There is even less seatbelt use in rural areas which causes an increase in motor vehicle collisions
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causing the need for EMS. With a longer wait time for EMS to reach patients for care, causes an

increase in the rate of deaths in these areas (About Rural Health, 2023).

With such a need for healthcare access for rural communities, there are three SMART

goals that are appropriate for this specific population and community.

SMART Goal #1: Rural community residents will attend at least one health visit for a

yearly physical.

SMART Goal #2: Rural community residents will be educated on seat belt use and

reduce the amount of car crash fatalities per year.

SMART Goal #3: Rural residents who suffer from multiple healthcare problems will

meet with a healthcare provider biannually.

Role of the Nurse

In the community healthcare setting, community nurses can bridge the gap between

accessible healthcare and rural communities. Since rural communities’ struggle to have adequate

healthcare access, community nurses help to act as the specialist for these residents. These nurses

help with obtaining and administering much needed medications to residents and providing

treatment for conditions and injuries that these residents are unable to get cared for at any larger

healthcare facility that urban communities have access to.

For rural community healthcare nurses, they focus on the patients as a whole, not just

their acute condition. Many rural nurses pride themselves on caring for the patients and all their

conditions which allows these rural patients to have maximized healthcare that they otherwise

would unable be receiving. An important part of community nursing is bringing awareness to the

rural community counterparts about the highly needed healthcare that rural communities need.

Rural healthcare nurses take their findings from their visits and create education that they then
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teach to rural residents and other communities about how to care for themselves when healthcare

access is limited.

Interventions and Health Promotion Plan

A major resource for rural community residents are the community healthcare nurses who

come and not only educate residents, but provide healthcare to them. A specific example of

educating the community includes the importance of using seat belts throughout the rural

community.  Along with enforcement in this policy, there has been community health

professionals, especially nurses, that come out to the community and educate citizens about the

importance of seat belt safety and explain that there will be an increase in enforcement in the

area to prevent and decrease these deaths. It is important for community healthcare nurses to

utilizes their education and advocating abilities to explain the importance of always using

seatbelts for rural community citizens. Nurses are a trusted profession and when citizens are

educated by nurses, there is a higher chance for these citizens to react and use this education in

their everyday lives (Rosseter, 2023).

Recently in this day and age, a huge technological advancement has paved the way for

rural communities is the use of telehealth medicine and serves as a breakage in the barrier of

healthcare access. Telehealth is a great approach to bringing healthcare to those who are too far

away in rural areas to receive needed healthcare. Although not all healthcare needs can be solved

using telehealth, but the majority can. Even the Center for Disease Control has a promotion plan

so that telehealth is accessible for rural communities (Telehealth in Rural Communities, 2022).

The use of telehealth medicine is sed to monitor chronic healthcare conditions such as heart and

lung conditions and with these increased monitoring, there are less deaths and admissions to
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hospitals. Telehealth does a great job in aiding in the education of rural community members.

With the use of videos, healthcare professionals can use the telehealth appointments to do hands

on teaching with patients to teach things such as diabetes management and even blood pressure

monitoring.

SMART Goal #1 Interventions: Community healthcare nurses to connect patients and

create appointments for residents to go to their yearly checkups. Rural community nurses can

also conduct these checkups themselves so that the access to healthcare is increased.

SMART Goal #2 Interventions: Rural community nurses will conduct educational

classes at least once or twice a year at community buildings such as fire houses or event centers.

These classes will aid in educating residents on the importance of using seat belts and how not

using them can result in not only injuries, but death. There will be statistics explained and even

videos showing what wearing a seatbelt does to a body.

SMART Goal #3 Interventions: Telehealth medicine will be accessible to all rural

residents. This can be obtained by either educational classes teaching residents how to set up and

use telehealth on their own devices, or there can be a telehealth machine such as an iPad placed

in a community center that residents are able to use for their appointments.

Evaluation

Obtaining financial resources for telehealth medicine to be enacted may take longer, but

educational classes can be set up easily. Once telehealth is set up, the total use of this

intervention will be evaluated by the number of residents who go to their appointments. This can

be evaluated every six months to see how well this technology has increased the access to
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healthcare for residents. It will take a bit to get acquainted to, especially for residents who are not

already familiar in telehealth services. When this service gets started, it will be evaluated after

the first year and then biannually after that. The educational meetings regarding seat belt use will

also occur biannually and at the end of each year the total number of seat belt related injuries and

deaths will be evaluated to see if there is any positive changes.

Although it is easier said than done, with the increase in technology there are many ways

to end the gap between limited healthcare in rural areas. Some ways include information sessions

on screening patients for blood pressure and even cancer prevention. Using telehealth for these

information sessions would benefit these patients in rural areas. With providing more ways for

these patients to gain access to care, there will be a lower chance for diseases and death in rural

area residents.
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References

About Rural Health Care. NRHA, National Rural Health Association. (n.d.).

https://www.ruralhealth.us/about-nrha/about-rural-health-care

Centers for Disease Control and Prevention. (2023, May 9). About Rural Health. Centers for

Disease Control and Prevention. https://www.cdc.gov/ruralhealth/about.html

Centers for Disease Control and Prevention. (2022, September 8). Telehealth in Rural

Communities. Centers for Disease Control and Prevention.

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/telehealth-in-rural-

communities.htm

Rural Health Disparities Overview - Rural Health Information Hub. Overview - Rural Health

Information Hub. (n.d.). https://www.ruralhealthinfo.org/topics/rural-health-disparities

The Uninsured in Rural America. The Kaiser Foundation. (2003, April). https://www.kff.org/wp-

content/uploads/2013/01/the-uninsured-in-rural-america-update-pdf.pdf

U.S. Government Accountability. (2023, June 8). Why health care is harder to access in rural

America. U.S. GAO. https://www.gao.gov/blog/why-health-care-harder-access-rural-america