The National Rural Health Association recently held the 33rd Annual NRHA Policy Institute. As you may know, NRHA, a national, mission-oriented nonprofit with more than 21,000 members, provides leadership on rural health issues through advocacy, communications, education and research.
Ordinarily held in Washington D.C., the risk for the potential spread of COVID persists, so NRHA seamlessly hosted the successful and informative conference on a virtual platform. I was excited to attend and gained valuable insight from the many thought leaders. All the change-makers carried a similar calm yet were driven by a powerful sense of purpose.
Rural Healthcare Disparities
Rural healthcare is suffering.
Pre-COVID, the health disparities between rural and urban areas were already worsening, but the pandemic produced more challenges to address.
Take mental health, for example. Accessibility, availability and acceptability already were issues. Now, three in five rural adults (61 percent) report the “COVID-19 pandemic has impacted mental health in rural communities a lot or some.” Nearly three-quarters of rural youths (71 percent) say the pandemic has impacted their mental health. There is a higher risk of suicide in rural areas, with nearly twice as many suicides in the most rural counties compared to urban areas.
Consider the 60 million Americans who call rural America home – the farmers who provide our food, the hardworking, determined small business owners who refuse give up, the elderly who miss lifesaving treatments due to the unavailability of transportation, and our most deserving citizens, the proud military veterans, many of whom return to rural America to live in isolation with PTSD and little access to behavioral healthcare. The problems are many and the scale is almost too large to comprehend. I’ll admit that it is tempting to be discouraged, but one of the gifts of attending the NHRA Policy Institute is the optimism I now feel.
Fortunately, there is a path forward paved by intelligent, dedicated researchers, community organizers, teachers, nurses, employers and so many more who have learned how to advocate for change and fight for strong rural healthcare infrastructure.
Each year, NRHA members write and review Advocacy Position Papers that present compelling arguments for a specific position or a convincing solution to a problem, such as mental health in rural America. These briefs are researched and well-reasoned cases to gain support and provide key decisionmakers and legislators the tools they need to justify implementing the proposed solution. This can happen by creating new laws or appropriating funds to pay for programs, equipment or education.
Roughly 200 papers are presented annually at a the NRHA Annual Call for presentations. This year, six were accepted:
- Mental Health in Rural Areas, February 2022
- Rural Emergency Hospital Conversion, February 2022
- Rural Health Clinics, February 2022
- Rural Public Health, February 20222022 NRHA Policy Papers
- Structural Factors that Impact Rural Life Expectancy, February 2022
- Toward a Sustainable and Diversified Rural Health Workforce, February 2022
At the Policy Institute, NRHA publishes and distributes two documents the rural health priorities they have determined are most important and require the most immediate attention and resources: the 2022 Policy Agenda and the 2022 Advocacy Requests.
The 2022 NRHA priorities are:
- Addressing rural declining life expectancy and rural health equity,
- Reducing rural healthcare workforce shortages, and
- Investing in a strong rural safety net.
The 2022 requests to address rural health equity are:
- Establish an office of rural health within the CDC.
- Expand access to maternal health services.
- Congress should permanently expand tele-health provisions.
The 2022 requests to strengthen the rural health workforce are:
- Expand the Medicare Graduate Medical Education (GME) Program.
- Provide supplemental appropriations for initiatives like the National Health Service Corps and Nurse Corps Loan Repayment Programs.
- Expand the nursing workforce to ensure rural communities have access to care.
Stay tuned. As write this blog, President Biden has just signed the compromise for the fiscal year 2022 appropriations package, which includes critical support for rural healthcare and rural hospitals. It’s definitely a step in the right direction and there is undoubtedly much more work to do by those of us are advocates for rural health.