Health Care

Disparities:
Rural Nursing
By: Amber Dykstra and Kim Karwowski

Introduction
Throughout the world there are millions of
people in rural settings who do not have
appropriate healthcare to meet their needs. In
the United States alone there are thousands
who do not have healthcare services needed to
provide accurate care.

Objectives
Identify the rural setting population and the

nursing experience needed to assist in care

Assess the medical needs of patients in the
rural setting
Understand that rural nurses must have a
broad knowledge base
Distinguish rural nursing locations

A National Rural Health Snapshot

Rural

Urban

nearly 25%

75% +

10%

90%

40.1

134.1

18%

15%

14%

11%

$19K

$26K

83%

69%

Adults who describe health status as fair/poor

28%

21%

Adolescents (Aged 12-17) who smoke

19%

11%

80

60

40

30

64%

69%

23%

20%

45%

31%

85%

106%

90%

100%

45%

49%

Percentage of USA Population**

Percentage of USA Physicians**
Num. of Specialists per 100,000 population**
Population aged 65 and older
Population below the poverty level
Average per capita income
Population who are non-Hispanic Whites

Male death rate per 100,000 (Ages 1-24)

Female death rate per 100,000 (Ages 1-24)
Population covered by private insurance
Population who are Medicare beneficiaries
Medicare beneficiaries without drug coverage
Medicare spends per capita compared to USA
average
Medicare hospital payment-to-cost ratio
Percentage of poor covered by Medicaid

Disparities
Funding
Quality of care
Lack of preventative services
Patients more likely to have comorbidities
Shortage of providers
Access to care

Root Cause Analysis

Rural areas consist of 19.3% of the United States population
Only 10% of physicians practice in rural settings
Rural residents are less likely to have employer-provided

health care coverage or prescription drug coverage

Rural patients are less likely to be covered by Medicaid
benefits than their urban counterparts.
People in rural areas tend to be poorer
Fewer resources available
Lifestyles may influence healthcare prioritization

Reimbursement

Implications
Increased likelihood to diagnose diseases at a

later stage potentially resulting in a lower

survival rate
Delay in seeking treatment for early
presentation of disease
Patients continue to have return visits for
uncontrolled comorbidities
Reduced resources for care management
Less likely to have specialty treatment options

Comparison view map of RNs and

Population Density

Nurses role
Educator
Advisor/Confidant
Understands and educated in multiple

disciplines
Involved in the community
Creativity in delivering services

Strengthening Community
Connections

Recommendations
Prevention
Recruitment
Support rural nurses
Education
Awareness

Conclusion and Summary

Rural nursing requires multidisciplinary skills
Strengthening community relations is

essential
Prevention education
Awareness of resources

References

Arizona Department of Health Services. (2014). The Picture of Health.

Retrieved from http://publichealthblog.azdhs.gov/wpcontent/uploads/2014/04/Health-Screenings-by-Age.jpg

Bureau of Labor Statistics. (2011). [Map of employment of registered

nurses per state May, 2011]. Occupational Employment of Nurses and
Wages. Retrieved from
http://www.bls.gov/oes/2011/may/oes291111.htm

Casey, M., Call, K.T., and Klingerman, J.M. (2001). Are rural residents
less likely to obtain recommended preventative healthcare services?
American Journal of Preventative Medicine, 21(3). Retrieved from
http://0www.sciencedirect.com.libcat.ferris.edu/science/article/pii/S07493797
0100349X

Centers for Disease Control and Prevention. (2014). NCHS data brief.
Retrieved from http://www.cdc.gov/nchs/data/databriefs/db159.htm

References Continued
Centers for Disease Control and Prevention. (2013).

Strengthening Community Connections. Retrieved from

http://www.cdc.gov/pcd/issues/2013/images/12_0272_01.gif
Cropley, S. (2014). Rural health disparities.Texas
Nursing,88(1), 14-15.
Hauenstein, E. J., Glick, D. F., Kane, C., Kulbok, P., Barbero,
E., & Cox, K. (2014). A model to develop nurse leaders for
rural practice.Journal of Professional Nursing,30(6), 463473
National Rural Health Association [NRHA]. (2015). [Rural
population statistics]. A national rural health snapshot.
Retrieved from http://www.ruralhealthweb.org/go/left/aboutrural-health/what-s-different-about-rural-health-care

References Continued

National Rural Health Association. (2015). Whats different about rural

healthcare? Retrieved from http://www.ruralhealthweb.org/go/left/aboutrural-health/what-s-different-about-rural-health-care

Rosenthal, Kay. (2000). Rural nursing. The American Journal of Nursing,

100(4). Retrieved from http://0www.jstor.org.libcat.ferris.edu/stable/3522012?
seq=1#page_scan_tab_contents

United States Census Bureau. (2010). How many people reside in urban
or rural areas for the 2010 census? What percentage of the population of
the U.S. population is urban or rural? Retrieved from
https://ask.census.gov/faq.php?id=5000&faqId=5971

United States Census Bureau. (2010). [Map of population density, 2010].

2010 Census Results-United States. Retrieved from
https://www.census.gov/2010census/news/pdf/cb11cn123_us_totalpop_20
10map.pdf