VHA Office of Rural Health

Rural Health Care Challenges

ORH enhances the health and well-being of rural Veterans by increasing access to care and services through diverse programs. These initiatives follow ORH's model of "research, innovate, and disseminate," aimed at supporting about 3 million rural Veterans enrolled in the VA health care system.

The rural Veteran population is aging, with 54% being 65 or older. These Veterans are often medically complex, with higher rates of diabetes, obesity, hypertension, and heart conditions, requiring frequent and costly care. Additionally, the next generation of rural Veterans faces multiple medical and combat-related issues, necessitating ongoing access to care.

Rural Veterans face significant barriers to accessing high-quality health care, including:

• Geography and travel distance, including transportation issues
• Limited broadband access, which impacts the ability to use telehealth
• Rural healthcare workforce shortages, and
• Social needs like housing, food security, and social isolation.

Traveling long distances for health care, and for basic items like groceries, may be especially difficult for rural Veterans with mobility issues, and elderly rural Veterans. Geographical features like rivers and mountains – while beautiful to look at and a perk of being rural – can extend drive times. Lack of public or private transportation, or lack of a driver - whether a family member, friend, or hired service; is a barrier to access. In many rural areas, RideShare services are not a reliable option.

Internet access has come to the pocket of most every American, though many rural communities remain without the technological infrastructure to deliver quality virtual care through telehealth. Many older Veterans lack the skills to use new technology or have not warmed to learning to use it. This creates a huge barrier to engaging rural Veterans in telemedicine and connecting them to a world of health information.

Technology barriers also contribute to a ‘disconnect’ with social support networks; which influence overall health and well-being. Older Veterans need support to navigate the information superhighway; safely and effectively.

Social needs such as transportation, housing, education, employment, and food have a direct connection to health. Energy insecurity has recently been acknowledged as contributing to mental health symptoms like anxiety. Unmet social needs must be addressed to care for the Veteran’s whole health.

The availability of a highly trained healthcare workforce in rural communities also limits Veterans access to care. Urban amenities and conveniences, as well as employment opportunities, draw clinicians away from already drained health care talent pools.

ORH addresses these challenges through a four-part mission:

• Promoting rural Veterans' health and well-being
• Generating and disseminating knowledge,
• Strengthening community health care infrastructure, and
• Informing rural health care policy.

ORH's programs and initiatives serve as exemplary models for both VHA and community health care systems, demonstrating a commitment to improving rural Veterans' health and well-being.

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