Strategies for Accessible Healthcare for People with Disabilities Living in Rural Communities
July 17, 2024 | Ty B. Aller, Audrey Juhasz
Access to adequate care can often be difficult in rural communities, where public health and healthcare infrastructure is stretched. Rural communities are in need of more robust services to effectively improve the well-being and quality of life for people with disabilities who also experience chronic health conditions (CHCs) and frequent mental distress (FMD). Services to address these concerns are already underfunded and stressed. Effective solutions will require both specialization and community engagement to be successful.
To help aid health officials address these growing concerns, researchers at the Institute for Disability Research, Policy and Practice at Utah State University, aided by funds from CDC and in collaboration with ASTHO and The Association of University Centers on Disabilities, sought to better understand the prevalence and trends of CHCs and FMD among people with disabilities living in the intermountain west.
Using data from the Behavioral Risk Factor Surveillance System collected by CDC, researchers wanted to understand how urbanicity impacted the prevalence of CHCs and FMD. These two aspects were selected because they represent aspects of both physical and psychological health. In two reports, researchers found that adults with disabilities in the United States were more likely than people without disabilities to experience CHCs and FMD. Surprisingly, CHCs and FMD were both not more common among people with disabilities living in rural communities compared to urban communities. This is critically important because it suggests that people with disabilities living in rural areas are just as likely to develop a CHC or experience mental distress as those living in urban areas. However, healthcare resource availability is typically lower in rural communities compared to urban communities due to differences in economic and healthcare infrastructure. This suggests that although people with disabilities are just as likely to develop concerning physical and psychological conditions, they may have more difficulty getting the services they need. To address these disparities, it is critical that public health and healthcare infrastructure is expanded in rural areas. However, rural communities can be resistant to sudden and large change instituted by those outside of the community, so balance and community buy-in are vital to long-lasting and sustainable change.
Actionable Strategies for Health Agencies
Step 1: Shift focus from “curing” disease processes to promoting community engagement, inclusion, and well-being.
Too often, programming for people with disabilities emphasizes trying to find “cures” for their concerns rather than promoting well-being through meaningful engagement and inclusion. People with disabilities may not view their disability as something to be cured or fixed but as an integral part of their identity to be seen and supported. As health agencies continue developing responses to complicated health challenges, they can focus programming that improves health equity for people with disabilities and promotes meaningful engagement and genuine inclusion.
Step 2: Include and empower people with disabilities in planning state-wide responses to increase accessibility of healthcare services.
States are making concerted efforts to include communities in the development and delivery of health equity programming. However, a lot of work remains to expand accessibility to people with disabilities. This is especially important when considering delivery of programming through internet-based services, as broadband internet access is still severely lacking in the United States. Empowering communities to lead these efforts is crucial for long-term sustainability and effectiveness. This can be done by directly including people with disabilities in planning and also collaborating with groups like community health workers that can help tailor the development and dissemination of programming in ways that are more likely to be useful for communities. For example, following the COVID-19 pandemic, communities include people with disabilities in emergency preparedness planning to ensure that services are more accessible to all.
Step 3: Leverage the power of scalable, transdiagnostic programs.
The sheer variety and diverse needs of people with disabilities experiencing CHCs and FMD make it very challenging to provide effective programming to improve health equity. Because of this, it is essential for health agencies to consider using and/or incentivizing transdiagnostic programs that can simultaneously address varying conditions, like CHCs and FMD, while improving well-being. Online self-guided mental health programs are widely available and are often provided in low-cost, easily scalable formats. These programs work by having individuals practice mental health skills in a self-guided format that includes interactive activities based on empirically validated psychosocial interventions that are commonly used in in-person services. These programs are cost-effective and can be easily nested and disseminated in existing public health and healthcare infrastructure. Building upon these frameworks provides health agencies with low-effort, high-impact actions that can be included in strategic state-wide plans.
Ultimately, addressing the healthcare needs of people with disabilities in rural communities requires a multifaceted and inclusive approach. By focusing on community engagement, inclusion, and the empowerment of individuals with disabilities, health agencies can develop sustainable strategies that promote health equity. Leveraging scalable, transdiagnostic programs can further enhance the accessibility and effectiveness of healthcare services, ensuring that all individuals, regardless of their location, receive the care and support they need.