Presentation on theme: "HEALTH INEQUITIES EXPERIENCED IN RURAL V URBAN Alicia Haywood Policy & Advocacy Manager."— Presentation transcript:
HEALTH INEQUITIES EXPERIENCED IN RURAL V URBAN Alicia Haywood Policy & Advocacy Manager
Colorado Rural Health Center Definition of “rural” Coverage Health factors and outcomes Mental health Workforce Social determinants Opportunities for change Resources Overview
Non-profit membership organization State Office of Rural Health Programs & Services o Rural Health Clinics (52) o Critical Access Hospitals (29) o Provider Recruitment and Retention o Grant Programs o Community Development o Policy and Advocacy Colorado Rural Health Center
What is Rural?
Over 20 definitions of “rural” used by federal government in regards to healthcare One common definition is from the Office on Management and Budget – uses US Census data to describe “urban” Frontier = Less than or equal to six persons per square mile What is Rural?
“The demographics of rural America have a direct impact on many factors of healthcare delivery and outcomes, including rural residents’ health status, health insurance status, access to healthcare providers, and their communities’ economic viability.” report from the National Advisory Committee on Rural Health and Human Services
Lower Income and Higher Rates of Poverty
Avg. rate uninsured for rural is 23% as compared to 18% in urban Higher unemployment Self-employers and small businesses less likely to offer health insurance Hard to afford health insurance in rural (geographic rating) Limited availability of plans Coverage
Higher rates of suicide High rates of tobacco and alcohol use o Higher DUI rates o Higher methamphetamine and prescription drug use Concerns about privacy and confidentiality in counseling Shortage of mental health providers Lack of tele-health options Mental and Behavioral Challenges
Mental Health Counselors
Disparities greater for rural minorities o 15% of rural population Poverty rate for rural African Americans and Native Americans is 3x higher than Whites Rural minorities are more likely to engage in binge drinking, heavy drinking, and driving under the influence than urban youth (particularly in small rural towns <10,000) Rural Minority Disparities
56 counties were either fully or partially designated as a primary care HPSA 20% of Colorado’s healthcare workforce is over the age of 55 2 rural counties did not have an active licensed physician 9 rural counties did not have an active licensed dentist and 12 did not have a dental hygienist 7 rural counties did not have an active licensed pharmacist Workforce Shortages
Other Social Determinants Limited public transportation Travel time is longer for rural patients to get care 1/3 rd of all motor vehicle accidents occur in rural: 2/3 rds of vehicular deaths Higher levels of education enables better job opportunities and higher incomes AND Greater levels of understanding about health and healthy behaviors
Federal Affordable Care Act State Role of nurse practitioners, physician assistants, dental hygienists Medicaid expansion Oral health benefit in Medicaid Mental health options Marketplace subsidies and new insurance options Opportunities
References and Resources Department of Local Affairs Department of Local Affairs Robert Wood Johnson – County Health Rankings Robert Wood Johnson – County Health Rankings Livewell Colorado Livewell Colorado Department of Public Health & Environment Department of Public Health & Environment Colorado Health Institute Colorado Health Institute Colorado Rural Health Center Colorado Rural Health Center National Rural Health Association National Rural Health Association 2013 Snapshot of Rural Health in Colorado 2013 Snapshot of Rural Health in Colorado