Disparities and Inequalities in Rural Healthcare and Patient Movement


Rural hospitals face a harsher reality than their urban counterparts.

The U.S. Department of Health and Human Services (HHS) launched the Healthy People initiative in 2010, with the explicit mission to improve the quality of life for all Americans.1 “Rurality” is recognized by the initiative as one of its 14 health disparities because the accessibility of sufficient healthcare for rural residents is significantly less than that compared to people living in more densely populated urban centers.2

And unfortunately, the disparities and inequities of healthcare accessibility for rural residents continue to grow in severity due to the progression of several critical issues rippling throughout the entire healthcare industry. In our new eBook, The Recent Rise of Disparities and Inequities in Rural Healthcare, we examine three of the most recent challenges that hospitals in the country face today. Then we uncover through extensive research how these challenges disproportionately impact rural hospitals.

The three main challenges for hospitals today

Hospital staffing shortages

As reported by HHS, about 16% of all hospitals are experiencing critical staffing shortages.3 However, even before the nationwide spike in healthcare staffing issues, only 11% of all physicians practiced in rural areas. To make matters even worse, 65% of all healthcare professional shortages occur in these same areas.2

Hospital closures

Due to a lack of staff and a limitation of revenue-generating patient services spurred by the COVID-19 pandemic, many hospitals struggle to keep their lights on. Nationwide, there have been an average of 16.4 hospital closures since 2015, resulting in a decline in the number of hospitals from 1,887 to 1,805. Rural hospitals make up an astounding 59% of these closures.4

Response delays and EMS transportation times were already much longer in rural areas than urban ones. Now, as more rural hospitals close, transportation times are increasing — while the likelihood of positive patient outcomes decreases because of delayed access to care.5,6

Worsening socioeconomic factors

People in rural areas tend to be poorer and older than those in urban centers. They live in higher concentrations of poverty, and 18% of them are aged 65 years or older (compared to 13% of the urban population). Rural areas also saw a 0.4% rise in the unemployment rate from 2010 to 1018, while urban areas saw a 4% employment rate growth.6

Based on the preexisting socioeconomic conditions, it’s easy to assume that rural hospitals were already operating on tighter margins than urban ones. In fact, many of them were already operating in negative margins.7 But with rising unemployment and a dwindling population (a 2% decline was observed between 2010 and 20186), more rural hospitals will likely be shuttering in the coming months and years — ultimately resulting in an even greater disparity in healthcare access.

How to overcome disparities and inequalities in rural healthcare

Rural hospitals are tasked with providing positive patient outcomes to an older, sicker, and poorer population than hospitals in urban areas. To do so, these hospitals must contend with staffing shortages, fewer hospitals over greater distances of travel, and worsening socioeconomic conditions.

Download our eBook, The Recent Rise of Disparities and Inequities in Rural Healthcare. You’ll learn more facts and realities behind the challenges that put access to healthcare in rural areas at greater risk — and you’ll find out what can be done to overcome disparities and inequalities in rural healthcare.


  1. HHS announces the nation’s new health promotion and disease prevention agenda. https://www.healthypeople.gov/sites/default/files/DefaultPressRelease_1.pdf.
  2. Rural Healthy People 2020. Texas A&M Health Science Center. https://srhrc.tamhsc.edu/docs/rhp2020-volume-1.pdf.
  3. Vaccine Mandates Hit Amid Historic Health-Care Staff Shortage. https://www.bloomberg.com/news/articles/2021-10-02/vaccine-mandates-hit-amid-historic-health-care-staff-shortage.
  4. U.S. Rural Hospitals Fast Facts. American Hospital Association. https://www.aha.org/system/files/media/file/2021/05/infographic-rural-data-final.pdf.
  5. Rural Hospital Closures Maps, 2005 – Present. https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures.
  6. Affected Residents Had Reduced Access to Health Care Services. https://www.gao.gov/assets/720/711590.pdf.
  7. The Causes of Rural Hospital Problems. https://ruralhospitals.chqpr.org/Problems.html.
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