How the Rite Aid and Homeward partnership sheds light on health disparities for rural seniors
In May, Rite Aid announced a partnership with Homeward to provide in-home clinical care and remote monitoring services to Medicare beneficiaries in underserved rural areas. While the announcement is the latest example of retail clinics expanding their healthcare footprint, it also reflects a second, more troubling trend: Growing health disparities among rural seniors.
The Rural Health Information Hub notes that residents of rural areas have higher incidence of chronic disease and disability, lower life expectancy, and higher mortality rates than those in suburban and urban neighborhoods. Geographic isolation is certainly a factor – but so, too, is an increased likelihood of lower household income, joblessness, limited insurance coverage, and hospital closure.
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Efforts such as the Rite Aid and Homeward partnership shed light on five common barriers to care that healthcare stakeholders must address to reduce health disparities for rural seniors.
Not enough physicians. Two-thirds of the nation’s health professional shortage areas are in rural communities, even though rural areas make up just 14% of the U.S. population. This leads to longer wait times when patients need to schedule appointments, particularly for specialty care. It also leads primary care physicians to take on responsibilities typically associated with specialty care – for example, managing depression in the absence of an available psychiatrist.
Not enough pharmacies. It’s true that pharmacists are positioned to improve access to health in rural areas – especially as many are trained and licensed to do more than dispense prescriptions. However, pharmacies face similar business challenges in rural areas as hospitals, as roughly 16% of independent pharmacies closed between 2003 and 2018. This particularly impacts seniors with long-term care needs who live at home and require additional medication and care management assistance.
Inadequate housing. Rural seniors are just as likely to want to age in place as their suburban and urban counterparts. However, rural seniors are more likely to report that their home has unmet mobility needs, such as uneven stairs at the front door. As a result, they’re also more likely to worry about falls – about 20% of which cause a serious injury that limits seniors’ mobility and diminishes quality of life.
Inadequate transportation. A recent survey of state rural health offices found transportation is the top barrier to enabling seniors to age in place. This presents itself in many ways: Public transportation and ride share options are limited, healthcare facilities as well as grocery stores are far away, and inclement weather and mountainous terrain can limit access to resources for weeks at a time. As a result, seniors continue to drive even if chronic health conditions make driving difficult and risky.
Social isolation. Rural seniors have larger social networks and tend to be more active in the community than those living elsewhere – but this is offset by living alone and needing to travel greater distances for gatherings. As a result, rural seniors are more likely to report loneliness and social isolation, which increases the risk of depression and dementia while adversely impacting activities of daily living.
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Brian Eastwood is a Boston-based writer with more than 10 years of experience covering healthcare IT and healthcare delivery. He also writes about enterprise IT, consumer technology, and corporate leadership.