Rural Women and Chronic Disease

The Problem of Chronic Disease

Imagine having to drive over an hour to get a medication refilled or to have your blood pressure checked. This is a reality for many people in rural areas. Not surprisingly, death from chronic disease is higher among rural populations compared to urban ones. What exactly is chronic disease? Chronic disease includes long-term conditions that require ongoing care, like diabetes, hypertension, heart disease, and obesity. It is a growing problem in rural areas because of limited access to adequate care, socioeconomic barriers, and underfunded resources. 

The prevalence of chronic diseases is higher for rural women compared to their urban counterparts. For example, diabetes is 9-17% more common in rural areas. Rates of kidney disease, obesity, and smoking are also higher. Rural residents are also more likely to die from stroke, cancer, and respiratory disease. Chronic disease has negative implications for pregnancy and impacts long-term health and life expectancy.

Why is Chronic Disease More Prevalent in Rural Communities?

Several factors contribute to the higher prevalence of chronic disease in rural areas. First, access to adequate care is more limited. A shortage of qualified medical professionals and services, as well as hospital closures, prevents patients in these communities from receiving the care they need. In addition, the long distances they have to travel are another barrier. Socioeconomic challenges contribute to the problem. Higher rates of poverty and uninsurance mean more people forgo care. Availability of healthy food options and wellness programs, including gyms and in-person exercise programs, is more limited. In addition to lower physical activity and poorer nutrition, smoking rates are higher. And because of geographic isolation, preventive care is less accessible. For instance, rural women are less likely to get mammograms and Pap screenings. Chronic disease is often diagnosed later and treated less effectively.

Why is Chronic Disease Harder to Treat in Rural Settings?

Not only does the lack of clinicians, including specialists, and resources prevent adequate management of chronic disease, but care is also more fragmented in rural areas. While telehealth is a promising development, with demonstrated improvement in blood pressure and diabetes management through remote monitoring, there are ongoing technological limitations, including interrupted and uneven broadband and limited digital literacy. Policy priorities that can address these problems include greater investment in rural health care, expansion of Medicaid, incentives for providers to practice in these communities, community-based programs to address nutritional and physical activity needs, and further development of digital infrastructure.

Why Should We Care?

Chronic disease affects not just an individual but a family as well. And there are ripple effects in the community, impacting workforce participation and the need for social services, with economic consequences. Rural women are often the primary caregivers, so when their health is compromised, the detrimental effects snowball. But many of these problems are preventable with better and more consistent care. It is imperative to support policy priorities to prevent the widening of rural-urban disparities.