Rural–Urban Mental Health Disparities In The United States ✓ Solved

Rural–Urban Mental Health Disparities in the United States During

The present commentary addresses how health disparities for preexisting conditions place rural residents at greater risk for morbidity during COVID-19. Reasons for physical and mental health disparities, such as limited access to hospitals or specialty providers (e.g., psychiatrists), are described. Whereas telehealth is promoted as a way to meet health access needs, especially during a pandemic, this luxury is not readily available for all U.S. residents. Recent actions brought about by the government (e.g., the CARES Act) have tried to address the rural–urban gap in telehealth, but more is needed.

By April 2020, the United States had more confirmed coronavirus 2019 (COVID-19) cases and deaths than any other country in the world. The geographical dispersion of the population made it challenging to address COVID-19 systematically. Each state governor proposed its own restrictions. Within each state, counties underwent unequal infection rates. More research is necessary to understand the magnitude of threat this pandemic poses in rural counties.

Around 85% of the population resides in urban counties, yet 63% percent of U.S. counties classify as rural. However, in truth, rural–urban health disparities are a risk now more than ever. Rural communities are disproportionately affected by several health issues, such as heart disease, cancer, and stroke, which primes them for higher risk of morbidity during COVID-19. Rural communities often have a higher percentage of people who struggle with substance use and mental health problems. Between 2001 and 2015, the suicide rate was nearly 1.5 times higher in rural than in urban counties.

Two reasons behind mental health disparities are (a) poor access to health care and (b) limited availability to skilled mental health providers. Rural hospitals faced an increasing risk of closures. Between 2010 and 2019, 98 rural hospitals closed. Rural counties also have fewer psychiatrists and psychologists than urban counties. Data show that in some states, more than 50% of their counties do not have a psychiatrist or psychologist. These preexisting reasons for health disparities, as well as other challenges posed by living in a rural community, exacerbate mental health issues during COVID-19. Around the world, anxiety has driven people to respond by panic buying. Social distancing practices introduced feelings of isolation, disconnection from routines, and put residents at risk for depression.

The state of mental health in the United States is further complicated by the fear felt by the 22 million unemployed. Yet, for rural communities, the situation was more odious because they were experiencing all of these issues along with higher rates of preexisting conditions and lower access to health care. One approach to addressing mental health needs during COVID-19 is telehealth. However, telehealth requires broadband access, the capacity to pay for technological devices like a smartphone or laptop, and a certain level of skills in operating this technology.

That means for rural, older, and other vulnerable U.S. populations, telehealth is not currently a solution for the inequalities in mental health access. From a mental health perspective, lack of broadband access during COVID-19 intensifies the vicious cycle of poverty and mental health across generations. The Federal Communications Commission (FCC) estimates that 21.3 million Americans do not have access to broadband, but other figures suggest that it is 42 million individuals. For youth, no broadband access means no engagement in remote learning activities; therefore, students will be disconnected from peers or mentors and be more behind in learning milestones than urban or wealthier peers.

For adults, no broadband access results in a limited capacity to work remotely. For all ages, especially the aging population, lack of broadband access means that grocery delivery apps are not a viable solution to the lack of resources. Therefore, the scarcity of broadband isolates rural communities further, inhibits residents from taking advantage of educational and economic opportunities, and bars prospective patients from receiving telehealth treatment to overcome the emotional challenges brought about by the pandemic. From a national level, the government instituted several changes during the pandemic to bridge the broadband gap.

Despite these changes, several issues are still not addressed. First, although $100 million was invested in increasing broadband access, $80 billion is needed to bring broadband to all U.S. residents. Second, the $200 million invested in the telehealth program assumes that patients already have broadband access. Lastly, the sustainability of the changes brought by this money is uncertain. For now, communities face new mental health challenges each day, and locally driven approaches have filled the gaps where governmental resources have not reached. Schools offered meal pick-ups or drop-offs using the bus route so that youth did not go hungry.

In another endeavor, a hospital created an emotional support hotline available to all people who experienced anxiety and stress during COVID-19. Finally, there are anecdotal stories of residents buying meals to donate to hospital staff on the front lines or teachers delivering printed school materials so that students from disadvantaged backgrounds are not left behind. Without a system-wide change to broadband access, economic, physical health, and mental health disparities will persist. In the meantime, grassroots movements will continue to thrive in times of need.

Paper For Above Instructions

The COVID-19 pandemic unveiled and exacerbated preexisting rural-urban mental health disparities in the United States. Rural populations face significant challenges that affect their physical and mental health outcomes, primarily due to inadequate access to healthcare services, socioeconomic factors, and technology gaps. Understanding these disparities is vital for health policymakers and providers aiming to mitigate the negative effects of such health crises.

The contrast in health outcomes between urban and rural communities has been documented in various studies. Rural residents experience higher rates of chronic diseases such as obesity, diabetes, and cardiovascular issues, driven by limited access to healthcare facilities and services (Kulshreshtha et al., 2014; Moy et al., 2017). The COVID-19 pandemic worsened these existing conditions, as social distancing and lockdowns increased morbidity and mortality rates among these populations (World Health Organization, 2020).

Moreover, the mental health of rural residents has significantly deteriorated during the pandemic. The fear and anxiety associated with the uncertainty of the pandemic, combined with social isolation, have heightened feelings of loneliness and depression, particularly among older adults and those already struggling with mental health issues (Long, 2020). As noted by Zhou et al. (2020), mental health crises that often emerge in urgent situations like the pandemic are magnified in isolated populations without sufficient mental health resources.

The mental healthcare system in rural areas already faces acute shortages, with limited access to psychiatrists and psychologists. According to the Centers for Disease Control and Prevention (2020), many rural counties lack adequate mental health providers, making it exceedingly difficult for individuals to access necessary care. As a result, telehealth was proposed as a viable solution to bridge this gap; however, this approach is hindered by the lack of broadband access in many rural areas (Leite et al., 2020).

Numerous challenges prevent effective telehealth implementation in these communities. The FCC estimates that as many as 42 million Americans lack access to broadband services, which affects their ability to engage in remote consultations (Busby et al., 2020; Giorgi, 2020). Consequently, this digital divide disproportionately affects rural populations, hindering their ability to access mental health services during a critical time.

Governmental responses such as the CARES Act have attempted to address these disparities by allocating funds to enhance broadband infrastructure and telehealth programs. However, while the funding is a step in the right direction, it remains insufficient to solve the underlying issues (Giorgi, 2020). The million-dollar investments underscore a necessary acknowledgment of the problem, but experts argue that a comprehensive strategy is required that entails substantial collaborative efforts between governmental and non-governmental entities (Ohannessian et al., 2020).

Additionally, the implications of poor broadband access extend beyond mental healthcare. The stark reality is that students in rural areas risk falling behind in their education without reliable internet access for remote learning, further increasing disparities in educational outcomes (Giorgi, 2020). Families are affected as well, particularly those with children who can no longer engage in routine school activities, resulting in increased stress and anxiety levels for both parents and children alike.

In response to the heightened need, grassroots initiatives have emerged in many rural communities to address these challenges creatively. Schools and healthcare providers have adapted by implementing meal delivery services and emotional support hotlines to assist families grappling with food insecurity and mental health problems caused by the pandemic (Forde, 2020; Barnett, 2020). These local responses play a crucial role in delivering immediate assistance where formal systems have failed.

Nevertheless, for rural communities to thrive beyond the pandemic, systemic changes regarding broadband access and mental health care delivery are imperative. Policymakers must prioritize long-term investment in both physical and mental health infrastructures, ensuring availability of healthcare services and technology access for all residents. Mental health training for rural healthcare providers could help bridge gaps in available treatment options, fostering a more integrated approach to rural health management.

Going forward, it is essential to recognize that socioeconomically vulnerable populations require robust support systems to navigate public health crises effectively. The pandemic has exposed the fragility of rural healthcare systems, rendering it necessary to push for innovative solutions that encompass all dimensions of health equity, extending beyond just physical health access to include mental health and socioeconomic stability.

References

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