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Rural Americans are dying from COVID-19 at twice the rate of urban Americans, Springfield hospitals explain why

Published: Oct. 4, 2021 at 9:57 PM CDT
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SPRINGFIELD, Mo. (KY3) - Rural Americans are dying of COVID-19 at more than twice the rate of people in urban areas, according to a recent study.

According to data from the Rural Policy Research Institute, rural areas are now seeing higher death tolls from COVID-19 even though many of America’s large cities were the first places to get hit by the pandemic.

“If you study the history of infectious diseases and pandemics, you do see the first waves hitting highly concentrated areas cities,” said CoxHealth President and CEO Steve Edwards. “And generally thinking we’re safer in the rural areas, but almost always the infection spreads because of the nature of patterns of travel back and forth to larger cities. And so almost always rural areas are hit less earlier, but generally, almost equally as hard. And in this case, maybe harder in terms of mortality.”

More than a year into the pandemic and several surges and waves later, rural death rates have shot up. Data from the Rural Policy Research Institute shows 1 in 434 rural Americans have died from COVID. That number is higher than in urban America where it sits at 1 in 513.

”Missouri was a hot spot for a while because our vaccination rates were low,” said Dr. David Barbe, Mercy Vice President of Primary Care. “So we know that we’re going to see more illness and more severe illness in areas of the state and the country where the vaccination rates are the lowest.”

Vaccination rates still sit under 50% in some parts of Southwest Missouri, and in other spots, it even sits under 30%. But experts say the issue does not stop there.

”Rural residents have disparities in health, pre-COVID before this pandemic ever started,” Barbe said.

He said older populations and higher rates of chronic disease are two other major factors.

”It’s not surprising that of the number of people in a rural area who get COVID there may be more who get severe COVID partly because of chronic disease, and partly because of age,” Barbe said.

Another pre-pandemic contributor is a lack of access to care.

“If we characterize rural areas, compared to urban areas, we see fewer physicians per 100,000,” Edwards said. “Access to care is a challenge in rural areas, and certainly, across the country. We’ve seen hospital closures in rural areas, making it more difficult to get care.“

Edwards said recruitment can sometimes be difficult in rural areas. While some rural towns have regional hospitals or medical centers, Barbe said they can still face challenges.

”Even some of those small hospitals as good as they are, are not able to provide the intensive care that is sometimes needed for individuals that are really sick,” he said. “So it’s not surprising that sometimes rural residents will delay seeking care until the illness is more advanced.”

At that point, Barbe said they may be transferred to a larger hospital out of the area. This is exactly why some large hospitals now treat more rural patients.

“When I look at our data in the last two months, in general, about 15 to 20% of our patients are from Greene County, and the majority of others are from the area surrounding us, typically a little bit more rural than Greene County,” Edwards said. “We do have maybe 5% that may come from further away. Most recently during Delta, that had to do with access to hospitals. We’ve had patients from Colorado and Alabama and North Carolina, for example, just because there wasn’t access in those states for care.”

Data from the University of North Carolina shows 181 rural hospitals have closed since 2005. Another 2020 report found more than half of US counties do not have a hospital with intensive care unit beds.

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