Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, etc). 3. To enter and activate the submenu links, hit the down arrow. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links.

Office of Rural Health

Menu
Menu

Quick Links

Veterans Crisis Line Badge
My healthevet badge
EBenefits Badge
 

RURAL VETERANS

Rural Communities | Rural Veterans' Demographics | Rural Definition |
Rural Veterans Health Care Atlas FY 2015 |
Rural Veterans Health Care Atlas FY 2014

Rural Veterans' Health Care Challenges

A quarter of all Veterans in the United States, 5.2 million, returned from active military careers to reside in rural communities. Veterans choose rural communities for a variety of reasons: closer proximity to family, friends, and community; open space for recreation; more privacy; lower cost of living; or less crowded towns and schools. While they may enjoy the benefits of rural living, these Veterans may also experience typical rural health care challenges that are intensified by their combat-related injuries and illnesses.

Just like any rural resident, it may be difficult for rural Veterans and their caregivers to access health care and other services due to challenges of rural health care delivery, including:

  • Higher poverty rates
  • More hospital closings due to financial instability
  • Population health factors and “social determinants of health”
    • Challenges in access to health and wellness promotion efforts
    • Fewer housing, education, employment and transportation options
  • Greater geographic and distance barriers
  • Limited broadband internet
  • Higher uninsured rates
  • Safely aging in place in rural America

VA recognizes the disparities that rural Veterans may experience and allocates 32 percent of its health care expenses for rural Veteran care.

Rural Communities

As of fiscal year 2015: In rural areas, basic levels of health care, or preventative care, that support residents' long-term health and well-being, may not be available.

In rural areas, basic levels of health care, or preventative care, that support residents' long-term health and well-being, may not be available.
Compared to urban areas, rural communities:

  • Have higher poverty rates
  • Have more elderly residents
  • Tend to have residents with poorer health
  • Have fewer physician practices, hospitals and other health delivery resources

return to top go

Rural Veterans' Demographics

  • 5.2 million rural and highly rural Veterans with 2.9 million enrolled in VA
  • 44% of rural enrolled Veterans have at least one service connected condition
  • 57% of enrolled rural Veterans are aged 65+
  • 6% of enrolled rural Veterans are women
  • 9% of enrolled rural Veterans are minorities
  • 15% served in Iraq and/or Afghanistan
  • 54% earn less than $36,000 annually
  • 500,000+ enrolled rural Veterans cannot access broadband
  • 82% of enrolled rural Veterans have other health insurance (e.g. Medicare, Medicaid, Tricare, Private Insurance) in addition to their VA benefits

There are 2.9 million rural Veterans that make up 33 percent of the Veteran population enrolled in the VA health care system.

  • Rural Veterans enrolled in VA's health care system are also significantly older: 57 percent are over the age of 65
  • This older Veteran population is medically complex and more likely to be diagnosed with diabetes, obesity, high blood pressure, and heart conditions that require more frequent, ongoing and costly care
  • The next generation of rural Veterans also has multiple medical and combat-related issues which will require significant, on-going access to care. Nearly 435,000 rural Veterans served in Iraq and Afghanistan
  • 56 percent of rural Veterans are enrolled in the VA health care system - significantly higher than the 36 percent enrollment rate of urban Veterans

The VA recognizes the need to provide accessible care to rural Veterans and allocates 32 percent of its health care expenditures to rural Veteran care.

Rural Definition

VHA relies on a system called the Rural-Urban Commuting Areas (RUCA) to define urban, rural and highly rural land areas of the United States. In this system each census tract defined by the Bureau of the Census is given a score.

The VHA definitions are as follows:

  • Urban (U) - census tracts with RUCA scores of 1.0 or 1.1. These are tracts determined by the Bureau of the Census as being in located in an urban core and having the majority of their workers commute within that same core (1.0). If 30%-49% commute to an even larger urban core then the code is 1.1. (The distinction between 1.0 and 1.1 is not significant to VHA.)
  • Rural (R) - all tracts not receiving scores in the urban or highly rural tiers.
  • Highly rural (H) - tracts with a RUCA score of 10.0. These are the remotest occupied land areas. Less than 10 percent of workers travel to Census Bureau defined urbanized areas or urban clusters.

Note: In the RUCA system 10.0 is more sparsely populated than 10.1 - 10.6. The U.S. Department of Veterans Affairs (VA)considers the latter to be "regular" rural, not "highly" rural.

In addition, VHA recently added an "I" category to complement "U", "R" and "H".  The "I" value is assigned to veterans living on the U.S. insular islands (territories): Guam, American Samoa, Northern Marianas and U.S. Virgin Islands.

Rural Veterans Health Care Atlas FY 2015

The second edition of the Rural Veterans Health Care Atlas (fiscal year 2015) builds on the first edition of this comprehensive resource guide for rural and Veteran advocates (including, but not limited to, researchers, planners and policy decision makers, as well as clinicians and patient care teams) to enhance health care delivery to rural Veterans, enrollees and patients.

This edition features six areas of interest, with updates that reflect the VHA’s changes on the definition of rurality, the establishment of the Veterans Choice Program, and the reclassification of VHA medical facilities. The six chapters are:

  • Overview and Location of VHA Medical Facilities
  • Rural, Highly Rural, and Insular Island Patients Treated at Each VAMC
  • Veteran Population, Enrollees and Patients
  • VHA Health Services Outpatient Utilization by Rural Veterans
  • VHA Health Services Inpatient Utilization by Rural Veterans
  • Occupancy Rates
Chapter 8
Chapter 1 Chapter 2
Chapter 3 Chapter 4
Chapter 5 Chapter 6

Rural Veterans Health Care Atlas FY 2014

The Rural Veterans Health Care Atlas is a comprehensive resource guide for rural and Veteran advocates (including, but not limited to, researchers, planners, policy decision makers, as well as clinicians and patient care teams) to enhance health care delivery to rural Veterans, enrollees, and patients.

This first edition consists of 17 chapters. Seven are core chapters, which will be updated each fiscal year, and 10 are disease-specific. The core chapters are:

  • Veteran Population, Enrollees and Patients
  • Overview and Location of VHA Medical Facilities
  • Rural and Highly Rural Patients Treated at Each VAMC
  • Non-VA Medical Facilities in Rural Areas
  • VHA Health Services Utilization by Rural Veterans
  • Rural County Health Index
  • Health Technology Access (Broadband) in Rural Areas

The 10 stand-alone, disease-specific chapters are on the following topics: diabetes, stroke, post-traumatic stress disorder, alcohol use disorders, tobacco use disorders, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, chronic renal failure and obesity.

Chapter 8
Chapter 8 Chapter 9
Chapter 10 Chapter 11
Chapter 12 Chapter 13
Chapter 14 Chapter 15
Chapter 16 Chapter 17
VETERAN FISHING WITH CHILD