Rural Health

Those in rural areas are at greater risk for poor health with higher likelihood of disease or death

This population tends to be:

• older
• may live with a disability
• may be a veteran
• more likely to be uninsured
• more likely to have multiple health conditions (stroke, diabetes, heart disease, hypertension, arthritis)

In addition to the burden of traveling to access healthcare, medical centers are closing in rural areas.

Cancer, chronic lower respiratory disease and unintentional injury (motor vehicle, opioid overdose and substance abuse) are more common. Further, these risks are even higher for racial/ethnic minorities, tribal, and other diverse groups in rural areas. These risk differences, or rural health disparities, may be due to factors already mentioned and include higher rates of smoking, exposure to environmental hazards, lack of seatbelt use, food deserts (lack of access to healthy foods) and poverty. US Food & Drug Administration

Intersectionality With Brain Injury

People living in rural areas are more likely to sustain a traumatic brain injury and are more likely to have worse outcomes, including higher death rates compared to those living in urban areas. Rural areas typically provide less access to TBI pre-hospital services, high-level trauma units, neurosurgical interventions and rehabilitation services. Functional outcomes also tend to be worse. Additional barriers people with TBI face in rural areas include: lack of access to transportation, difficulties with cost and insurance and denial about the seriousness of the injury. Providers noted that people in rural areas would benefit from education about common symptoms following brain injury and the need for evaluation after an injury.

People should be evaluated for brain injury following an injury and appropriate referrals should be made. However, given the higher incidence of brain injury in rural areas and the lower likelihood to seek services, screening for prior history of brain injury should be conducted during each yearly routine visit and sports physicals. When an injury is found, cognitive screening should be conducted and customized accommodations should be provided. Referrals to further services, including telehealth, should be made as needed.