All people deserve the right to a healthy life, but healthcare equity and access can prove more difficult to achieve in rural communities.
Although approximately 20 percent of the US population is rural, only nine percent of US physicians work in rural areas. According to the CDC, rural populations are more likely to die from heart disease, cancer, injuries, respiratory disease and stroke than those in urban areas.
At Dartmouth Health, The Center for Advancing Rural Health Equity (CARHE) and the Center for Rural Health Care Delivery Science (funded by the Center of Biomedical Research Excellence, also known as COBRE), are working to find solutions to rural challenges like these.
Improving delivery and outcomes
The Center for Rural Health Care Delivery Science was created to develop a critical mass of clinician-investigators who focus on the study of healthcare in rural communities.
Made possible by a five-year $11.6 million grant from the National Institutes of Health as part of the COBRE program, the Center creates a repository of research resources. Together with community-engaged partners, these resources shape the way rural healthcare is understood and delivered, providing researchers with expert mentoring in medicine and science and strategic direction.
The Center is supported by two scientific cores: 1) Statistics, Informatics, and Qualitative Methods, and 2) Community Engagement and Outreach.
Some examples of ongoing research include:
- Understanding and addressing barriers to remote cardiac monitoring, which relies on wireless connectivity and may be less accessible in rural areas (Project lead: Emily Zeitler, MD, MHS).
- Measuring the delivery of low-value pediatric services to determine disparities in rural vs. urban care and possible solutions (Project lead: Samantha House, DO, MHS
- Identifying why individuals with COPD who live in rural areas have worse health outcomes compared with their non-rural counterparts (Project lead: Laura Paulin, MD, MHS).
Ensuring health equity
Launched in 2022, CAHRE's mission is to ensure that people in rural areas have the chance to live healthy lives.
According to CAHRE’s website, “Rural health equity means that all people living in rural areas can live their healthiest lives. A healthy life includes living a life free from discrimination and unfair treatment.”
With a focus on rural health equity, CAHRE takes a community-driven approach to problem-solving. It works across research, healthcare, education, and community services, providing a unique network connecting all four groups.
Project partnerships are wide-ranging and innovative, sharing a common goal of working in partnership with the broader community.
Examples include:
- Working with recovery community leaders to create a Recovery Community Organization.
- Developing a food and nutrition support program with a Federally Qualified Health Center.
- Helping rural libraries to bolster early childhood education programming.
With oversight from a diverse Leadership Council, CARHE adheres to values of commitment, action, respect, and humility, while striving toward meaningful co-creation and community engagement.
Improving delivery and giving voice to the community
These two centers work in cooperation. They support researchers focused on improving the delivery of healthcare services in rural areas and on bringing the voice of the community to researchers. The partnerships with communities through research activities help improve the relevance and benefits of the research to rural populations.
This article first appeared in the October 2024 edition of Connections and has been modified for the web.