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Office of Rural Health


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About Rural Veterans

What is "Rural?"

The Department of Veterans Affairs uses the
Rural-Urban Commuting Areas (RUCA) system
to define rurality. Developed by the Department
of Agriculture (USDA) and the Department of Health
and Human Services (HHS), the RUCA system takes
into account population density, as well as how
closely a community is linked socio-economically to
larger urban centers.

  • Urban Area: Census tracts with at least 30
    percent of the population residing in an
    urbanized area as defined by the Census
  • Rural Area: Land areas not designed as urban
    or highly rural.
  • Highly Rural Area: Sparsely populated areas —
    less than 10 percent of the working population
    commutes to any community larger than an
    urbanized cluster, which is typically a town of no
    more than 2,500 people.

Map of enrolled Veteran population density, FY2010

There are 22 million Veterans nationwide, with 5.3 million who live in rural communities. Fifty-seven percent of these rural Veterans are enrolled in the U.S. Department of Veterans Affairs (VA) health care system. Between fiscal years 2006-2014, there was a seven percent increase in VA-enrolled rural Veterans.

Enrolled rural Veteran demographics for FY 14: 

  • 56% are 65 or older
  • 6% are women
  • 41% have service-related disabilities
  • 12% served in OIF/OEF
  • 39% earned less than $26,000 annually (FY 13)
  • 8% minorities (African-American, Asian, Native Hawaiian or Pacific Islander, American Indian or Alaska Native)

Rural Veterans experience several barriers in their ability to access care and services in their local community such as provider and specialist shortages, hospital closings due to financial instability, limited broadband coverage (for telehealth services), geographic barriers, or distance. Additionally, rural Veterans must counter social determinants of health that can impact their overall health and well-being: 

  • Access to health care services and wellness promotion efforts
  • Housing
  • Education
  • Employment
  • Transportation

Prior cross-sectional and longitudinal analyses indicate that Veterans who live in rural settings have greater healthcare needs than their urban counterparts. Specifically, rural Veterans have lower health-related quality-of-life scores and experience a higher prevalence of physical illness compared to urban Veterans. While prevalence of most psychiatric disorders is lower for rural compared to urban Veterans, rural Veterans with psychiatric disorders are sicker as measured by lower health-related quality-of-life compared with urban Veterans. These difference in health-related quality-of-life scores, which equate to lower self-rated health status, among rural dwelling Veterans, are substantial, clinically meaningful and associated with increased demand for healthcare services.

The top five states with the highest numbers of enrolled rural Veterans are Texas, North Carolina, Ohio, Pennsylvania and New York.

View the ORH Fact Sheet for more information about rural Veterans and the Office of Rural Health.

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