Module 3: Rural Health Disparities
This module introduces some of the health disparities that are a reality for many rural dwellers.
Approaches nurses can utilize to mitigate the impact of some disparities will be addressed.
Module Objectives:
1) Appraise barriers to optimal health care that exist in rural areas.
2) Analyze factors that impact access to care in rural areas.
3) Explore consequences of limited access to healthcare.
4) Explore ways nurses can promote health in areas of limited health care access.
Assigned readings:
Bushy, A. (2013). Health Disparities in Rural Populations Across the Lifespan. In C.A. Winters (Ed.), Rural
nursing: Concepts, theory, and practice (pp.225 – 239). Springer.
http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sw
w&AN=547705&scope=site
American Nurses Association (2015). Code of ethics for nurses: With interpretive statements. Silver
Spring, MD: ANA. (choose portions that will be valuable in your synthesis and application post)
https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk
&AN=1021757&scope=site
COVID – 19 and Rural Health Care. (2020). Online Journal of Rural Nursing & Health Care, 20(1),
1–5. https://doi.org/10.14574/ojrnhc.v20i1.626. Available at
https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d
b=ccm&AN=143781889&scope=site
Erwin, C., Aultman, J., Harter, T., Illes, J., & Kogan, R. C. J. (2020). Rural and Remote
Communities: Unique Ethical Issues in the COVID-19 Pandemic. American Journal of Bioethics,
20(7), 117–120. https://doi.org/10.1080/15265161.2020.1764139.
https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d
b=ccm&AN=144785432&scope=site
Shreffler-Grant, J.M., Nicols, E., Weinert, C, & Ide, B. (2013). Complementary Therapy and Health
Literacy in Rural Dwellers. In C.A. Winters (Ed.), Rural nursing: Concepts, theory, and practice
(pp.205- 214). Springer.
http://ssuproxy.mnpals.net/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=e680sw
w&AN=547705&scope=site
Be sure to take adequate time to peruse Rural Health Information (RHI) Hub and Center for Disease
Control (CDC) sites as well as other information linked into this module
Key points
• Communities in rural areas are impacted by policies developed at the national level.
• Competition between rural and urban areas in the domain of healthcare occurs increasingly as
resources become scarcer.
• Healthcare policies impact rural and urban areas in unique ways.
• A variety of social determinants may impact the health of individuals and families.
• Although health disparities occur in all settings, there are a number that are particularly
noteworthy in rural areas.
• Poverty often compounds other risks and vulnerabilities.
• A high proportion rural residents are among the ‘working poor’ and uninsured. Low income
correlates with lower educational levels, poorer nutrition, fewer preventative health care
practices, increased risk of trauma, developmental delays, inadequate immunization, and
increased chronic illness.
• Rural people are often older. Many elderly adults have a low fixed income, relying primarily on
social security benefits. They may have difficulty accessing additional benefits
Graded Assignment:
You will complete your next synthesis and application assignment. Synthesis and Application
assignments have two separate components. Please see the information in the Synthesis and
Application Assignment folder for a video and more detailed direction. Refer to the grading rubric
(Appendix B in your syllabus or at the end of this document) for how points can be earned. Carefully
note the criteria for a professional nursing journal as found in the course syllabus (p. 9).
Part 1: Choose one of the situations /topics below. You may need to refer back to information from
prior assigned readings in addition to the readings assigned for this module. Respond to the situation
you choose in the discussion forum adhering to the grading rubric in Appendix B. Note that all parts of
the discussion question/topic must be addressed to earn full points. You can earn up to 15 points for
your initial post.
Part 2: There is an opportunity to review what your peers have posted and build on their knowledge and
insights by the date included on the course schedule. You will post a substantive addition to one of your
peers’ post. Your substantive addition must address the topic/situation other than the topic/ situation
addressed in your original synthesis and application post. You can earn up to 10 points a substantive
addition that meets rubric criteria.
As you search for articles the first weeks of this course, two journals that may be especially helpful are
the Online Journal of Rural Nursing and Health Care and the Journal of Rural Health. Both are readily
accessible via the SMSU library. There are many other articles and journals that will be helpful as well.
Topic One
1. Examine three barriers that may impact access to health care (not including lack of services) that may
be especially prevalent in rural areas in the United States. Note: A professional examination
regarding this question should include at least three well thought out and professionally written
sentences examining each of the three barriers you choose.
2. What are some interventions nurses can implement to mitigate the impact of these barriers?
3. Compare and contrast potential barriers to access to care in rural versus urban areas.
Topic Two
1. How might limited access to health care impact the use of complementary and alternative therapies?
2. Discuss the long-term consequences of limited access to health care services. Include how limited
access impacts individuals, families, and the health care system.
3. Briefly discuss two provisions from the Code of Ethics with Interpretive Statements that are relevant
when considering health care disparities.
Appendix B: Synthesis and Application Assignment rubric
Remember that integrating your own thoughts with evidence from the literature is an effective to
demonstrate synthesis and critical analysis. Sometimes a few short direct quotes add value to your
work. But remember that long quotes generally serve to share someone else’s thoughts, rather than
your analysis.
Please refer to the Synthesis and Application folder for a more detail and guidance.
Primary post
Criterion Excellent Competent Not satisfactory
Complete All questions from one chosen
scenario/topic addressed in a
clear, focused manner. All
responses demonstrate critical
analysis (3 points)
In this module, students will learn about the health disparities faced by rural communities and the role of nurses in mitigating these disparities. The assigned readings cover the barriers to healthcare, factors impacting access to care, consequences of limited access, and ways nurses can promote health in areas with limited access. Topics such as social determinants of health, poverty, and aging population in rural areas will also be discussed. The students will complete a synthesis and application assignment where they will apply the information learned in this module.
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Sample Essay Answer:
Health disparities in rural areas have been a major concern for many years and continue to impact the health and well-being of rural residents. This essay will analyze the barriers to optimal healthcare in rural areas, examine the factors that impact access to care, discuss the consequences of limited access to healthcare, and explore ways in which nurses can promote health in areas of limited health care access.
One of the major barriers to optimal healthcare in rural areas is the lack of access to healthcare facilities and providers. Many rural residents live in isolated communities that are far from urban areas and hospitals, making it difficult for them to access healthcare services. In addition, rural areas often have a shortage of healthcare providers, which results in long wait times for appointments and limited access to specialized care.
The competition between rural and urban areas for resources is another factor that impacts access to care in rural areas. As resources become scarcer, rural areas often lose out to urban areas in terms of funding for healthcare facilities and services. This competition results in rural areas having limited access to the latest medical technologies and treatments.
The consequences of limited access to healthcare in rural areas are far-reaching and can have a significant impact on the health and well-being of residents. People living in rural areas are more likely to experience poverty, which compounds other risks and vulnerabilities. In addition, a high proportion of rural residents are uninsured, which makes it difficult for them to access necessary medical care. Low income levels in rural areas also correlate with lower educational levels, poorer nutrition, and a lack of preventative health care practices. All of these factors contribute to increased chronic illness and decreased overall health in rural communities.
Nurses can play an important role in promoting health in areas of limited health care access. One way to do this is by providing education and resources to rural residents on how to maintain good health and access necessary care. Nurses can also work with rural communities to develop telehealth programs that provide remote access to healthcare services. In addition, nurses can advocate for policies that address the disparities in rural health care, including increased funding for rural healthcare facilities and programs, and increased access to healthcare providers.
Health disparities in rural areas are a major concern for the health and well-being of rural residents. Addressing these disparities requires a multi-faceted approach that includes improving access to healthcare facilities and services, addressing poverty and low income levels, and promoting health education and resources. By working together, nurses and other healthcare providers can play an important role in improving the health and well-being of rural communities.
