Rural communities need support to decrease health disparities and improve access to care, say researchers

Rural communities in the United States face a dire health crisis that threatens the population’s well-being, says the American College of Physicians, in a new policy published today in the Annals of Internal Medicine. “Improving Health and Health Care in Rural Communities: A Position Paper from the American College of Physicians,” says that it is critical that policymakers prioritize and direct attention to improving rural health and health care.

“Rural residents face a higher risk for death from heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke compared with their urban counterparts. Rural communities are particularly affected by ‘diseases of despair’ and have had a dramatic increase in maternal mortality rates,” said Isaac O. Opole, MBChB, Ph.D., MACP, president, ACP.

“More needs to be done to help our patients who live in rural communities. Policymakers must invest in the economies, social services, and infrastructure of these areas, especially those programs that provide health coverage and services to them.”

Among the recommendations that ACP makes, they call for efforts to identify and address challenges that disproportionately impact rural populations. ACP reaffirms its call for policymakers to evaluate and implement public policy interventions that address underlying social drivers of health that disproportionately and negatively impact rural communities and perpetuate rural health inequities. Additionally, ACP urges policymakers to consistently and sufficiently fund and support health care programs and facilities that serve rural communities.

The paper goes on to highlight the need to better support physicians and other members of the health care workforce in rural areas, noting that medical education should incorporate education on rural health issues. ACP calls for increased efforts to increase and retain the rural physician workforce, including for efforts to expand opportunities for additional international medical graduates.

ACP recognizes the role that reimbursement plays in recruiting and retaining physicians in rural areas and urges policymakers to adopt incentives that support physician recruitment and retention. Finally, ACP says that appropriate exceptions should be made to licensure requirements for interstate care, in order to ensure access to telehealth services in underserved areas.

“While we are discussing the needs of rural communities overall, it is important to remember that these communities are very diverse,” concluded Dr. Opole. “They differ in demographics, culture, geography, isolation levels, and economic activity, meaning that there will not be a single policy approach that works for all of them. The public policy efforts aimed at rural populations must reflect the diverse needs of the communities they serve.”