Rural Populations

Abstract

Rural communities face more health inequities than urban areas. Social determinants of health are amplified by structural urbanism and contribute to barriers faced by rural communities, like limited transportation, long distances to the closest health organization, limited Internet access, low rates of health literacy, and workforce shortages. Although these barriers impact all rural residents, communities of color and other marginalized communities experience higher rates of poverty and negative physical and mental health outcomes. Indigenous rural populations have faced historic injustice and report experiencing serious psychological distress 2.5 times more than the general population. Rural immigrant and migrant agricultural workers experience significantly high levels of stress, depression, and substance use. Among rural LGBTQ+ communities, barriers include culturally insensitive health practices, low provider knowledge of LGBTQ+ health issues, and sometimes anti-LGBTQ+ stigma. Rural areas also face severe healthcare workforce shortages; approximately 65% of rural areas lack a psychiatrist, and primary care physicians often close the mental health and substance use treatment services gaps. Despite such challenges, several potential solutions exist to advance health equity in rural communities, especially through integrated healthcare strategies, telehealth, and other innovative models of care.