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University of Minnesota Profs Eye a Plan Toward Rural Health Equity
Minnesota Ag Connection - 08/18/2021

Professor Katy Backes Kozhimannil and Associate Professor Carrie Henning-Smith, both in the School of Public Health, study rural public health policy as leaders of the University of Minnesota Rural Health Research Center and the University of Minnesota Rural Health Program. The duo identified four key issues they think federal officials need to address in order to significantly improve the health of rural residents.

Kozhimannil and Henning-Smith say there's a critical need for increased rural representation in decision-making bodies at the federal, state, and local level.

"If we're going to begin thinking about how to improve rural health and invest in rural communities, we need to make sure that there are people with lived experiences from those areas at the table to ask the crucial questions, guide dialogue, and inform decisions," says Kozhimannil.

They suggest that state and federal guidelines require that advisory panels and committees include rural representation. They also recommend that officials systematically review the structures that put people in power in the first place to ensure that they allow rural people to hold seats and help make decisions.

To thrive, rural communities need well-paying jobs, transportation, housing, healthy food, education, health care, and environmental safety. To facilitate this, rural residents must be able to connect with one another and participate in broader society, both virtually and physically. An important first step in establishing those connections is creating universal access to broadband internet. According to the Federal Communications Commission, 80 percent of American households without reliable and affordable broadband access are located in rural communities.

"Broadband internet access in rural areas would expand access to health care via telemedicine and also could help address rural/urban inequities in education and employment as well as reduce social isolation," says Henning-Smith.

In rural areas, 20 percent of people are Indigenous or a person of color--and the percentage is growing, as indicated by the recent census results.

"Rural areas from the Black Belt to the border region to the plains and the Mountain West have always been racially diverse, and people of color and Indigenous folks face the greatest health inequities in the U.S.," says Kozhimannil. "In fact, rural people of color suffer from more health inequities than urban people of color and rural residents who are white."

The health inequities in rural areas are exacerbated by a lack of many resources that public health practitioners rely on to help people be healthier. Rural areas have fewer parks, sidewalks, food banks, and other community assets that aid in promoting good health and well-being. They also often lack public transportation to help residents take advantage of opportunities to be healthier in their communities.

Climate change is already significantly harming rural industries; namely, agriculture.

"Farmers are routinely seeing natural disasters and weather events devastate their farms and finances," says Henning-Smith. "Farming has never been easy, but the difficulties are heightened now and it's making growing crops and livestock unpredictable, forcing many farmers to operate in the red and feel more stress."

Climate change is an issue many governments across the country and the world are already trying to address and mitigate. Kozhimannil and Henning-Smith support those plans and encourage policymakers to consider how climate change harms rural communities and think of the best ways to help them when designing and implementing solutions.

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