Epidemiological sociology and the social shaping of population health. Affordability of health care is a significant challenge for rural areas in the southeastern United States. Emergency Order 10 - Requiring all sellers of groceries to temporarily transition to use of single use paper or plastic bags For example, lower socioeconomic status (SES) is associated with poor health care access, which may increase risk for adverse health outcomes. Health Insurance. Rural minority communities are particularly at risk because of a weakened health care infrastructure, health care provider shortages, and lower socioeconomic status. Rural communities face a unique set of challenges in the face of the coronavirus disease 2019 (COVID-19) pandemic. His last extension was on October 2, 2020, and was supposed to last through January 21, 2021, the day after President-Elect Joe Biden’s inauguration. Given the unique challenges for rural communities — exacerbated by a weakening rural health care infrastructure, health care provider shortages, and closure of rural hospitals — monitoring and control plans need to be developed to ensure that the magnitude of illness and death in those communities are assessed. HealthCare.gov in Other Languages. As the country responds to coronavirus disease 2019 (COVID-19), the role of public health in ensuring the delivery of equitable health care in rural communities has not been fully appreciated. Saving Lives, Protecting People, National Center for Chronic Disease Prevention and Health Promotion, U.S. Department of Health & Human Services. American Community Survey: 2010 data. We thank the Surgo Foundation for providing the data we used to create Table 2, COVID-19 Community Vulnerability Index Applied to 9 Southeastern US States. 05/04/21 - Director’s Amended Order for the Testing of the Residents and Staff of all Nursing Homes. Abbreviations: CCVI, COVID-19 Community Vulnerability Index; SES, socioeconomic status. Accessed July 1, 2020. Most recent hospital closings have been in states that opted not to expand Medicaid under the Affordable Care Act, which means that a significant portion of their health care costs remain uncompensated, thus creating a financial burden for these states (7). However, it can provide information about the anticipated negative impact at the community level. The State standards contained within this guidance apply to food services in operation during the COVID-19 public health emergency until rescinded or amended by the State. For example, in Mississippi, approximately 20% of the population lives in poverty (2). Hurricane Florence: Response by the Numbers, Office of the Assistant Secretary for Preparedness and Response, January 7, 2021: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic, October 2, 2020: Renewal of the Determination that a Public Health Emergency Exists as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic, July 23, 2020: Renewal of the Determination that a Public Health Emergency Exists as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic, April 21, 2020: Renewal of the Determination that a Public Health Emergency Exists as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) (formerly called 2019 Novel Coronavirus (2019-nCoV)) Pandemic, March 13, 2020: Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak, January 31, 2020: Public Health Emergency Declaration, March 13, 2020: Waiver of Modification of Requirements Under Section 1135 of the Social Security Act as a Result of the of the Consequences of the 2019 Novel Coronavirus, Declaration Under the Public Readiness and Emergency Preparedness Act for Medical Countermeasures Against COVID-19 (March 17, 2020), First Amendment to Declaration under the PREP Act for Medical Countermeasures against COVID-19 (April 15, 2020), Second Amendment to Declaration under the PREP Act for Medical Countermeasures against COVID-19 (June 8, 2020), Third Amendment to Declaration under the PREP Act for Medical Countermeasures Against COVID–19 (August 24, 2020), Fourth Amendment to Declaration under the PREP Act for Medical Countermeasures Against COVID–19 (December 3, 2020), Fifth Amendment to Declaration under the PREP Act for Medical Countermeasures Against COVID–19 (January 28, 2021), Sixth Amendment to Declaration under the PREP Act for Medical Countermeasures Against COVID–19 (February 16, 2021), Technical Correction to Fifth and Sixth Amendments to Declaration under the PREP Act for Medical Countermeasures Against COVID-19 (February 22, 2021), Seventh Amendment to Declaration under the PREP Act for Medical Countermeasures Against COVID–19 (March 11, 2021), First Advisory Opinion on the PREP Act Declaration (May 19, 2020), Second Advisory Opinion on the PREP Act Declaration (May 19, 2020), Third Advisory Opinion on the PREP Act Declaration (October 23, 2020), Fourth Advisory Opinion on the PREP Act Declaration (October 23, 2020), Fifth Advisory Opinion on the PREP Act Declaration (January 8, 2021), Sixth Advisory Opinion on the PREP Act Declaration (January 12, 2021), Guidance for National Guard Personnel Regarding COVID-19 Vaccines and Immunity under the PREP Act (December 18, 2020), Guidance for Department of Defense Personnel, Contractors, and Volunteers Regarding COVID-19 Vaccines and Immunity under the PREP Act (February 2, 2021), PREP Act Authorization for Pharmacies Distributing and Administering Certain Covered Countermeasures (October 29, 2020), Guidance for PREP Act Coverage for Qualified Pharmacy Technicians and State-Authorized Pharmacy Interns for Childhood Vaccines, COVID-19 Vaccines, and COVID-19 Testing (October 20, 2020), Guidance for Licensed Pharmacists and Pharmacy Interns Regarding COVID-19 Vaccines and Immunity under the PREP Act (September 3, 2020), Guidance for Licensed Pharmacists, COVID-19 Testing, and Immunity under the PREP Act (April 8. Rural communities are heterogeneous. Coronavirus disease 2019 (COVID-19) is a serious global pandemic. In 2010, 19.3% of the US population resided in rural areas, compared with 54.4% in 1910, with the highest concentration being in the southeastern United States. For example, a county score of 0 to 0.20 would correspond to very low vulnerability compared with all other US counties, a score of 0.21 to 0.40 would correspond to low vulnerability, and so on through the last category of very high vulnerability and a score of 0.81 to 1. Public Health Emergency - Leading a Nation Prepared, Home | Contact Us | Accessibility | Privacy Policies | Disclaimer | HHS Viewers & Players | HHS Plain Language, Assistant Secretary for Preparedness and Response (ASPR), 200 Independence Ave., SW, Washington, DC 20201, U.S. Department of Health and Human Services | USA.gov |
J Health Soc Behav 2008;49(4):367–84. Rural relevance — vulnerability to value, 2016. https://www.chartis.com/resources/files/INDEX_2016_Rural_Relevance_Study_FINAL_Formatted_02_08_16.pdf. Rural Health Information Hub. CDC twenty four seven. Healthcare access in rural communities. Emergency Order 8 - Temporary expansion of access to Telehealth Services to protect the public and health care providers. Data from the CCVI demonstrate that each of the 9 southeastern states has a CCVI score that indicates very high vulnerability. The Secretary of Health and Human Services (HHS) declared a public health emergency on January 31, 2020, under section 319 of the Public Health Service Act (42 U.S.C. Policy changes during COVID-19. The terrain can make it difficult, sometimes impossible, to install fiber or other infrastructure, and the biggest barrier to obtaining broadband internet service in certain areas of the country is low population density. Compared with urban hospitals, rural hospitals are smaller, have a higher proportion of primary care physicians and a lower proportion of board-certified physicians on their medical staffs, have fewer intensive care beds, and are less likely to have contracts with health maintenance organizations and preferred provider organizations. 2017. Another challenge is the temporary closures of health centers as a result of the pandemic. Sklar J. These stakeholders should include hospitals, health care centers, insurance providers, policy makers, community-based organizations, and faith-based organizations. Since the outbreak of COVID-19, health care delivery has changed considerably. Link BG. Accessed June 19, 2020. The commentary will also address how the COVID-19 Community Vulnerability Index may be used as a tool to identify communities at heightened risk for COVID-19 on the basis of 6 clearly defined indicators. Email: smelvin@advancingminorityhealth.org. However, several of the most rural states in the country opted not to expand Medicaid under the Affordable Care Act; 59% of uninsured rural people live in these states (16). 202. COVID-19 UPDATE Special coding advice during COVID-19 public health emergency Information provided by the American Medical Association does not dictate payor reimbursement policy and does not substitute for the professional judgement of the practitioner performing a procedure, who remains responsible for correct coding. Staffing to assist with contact tracing for COVID-19–positive people is also necessary. South Carolina: Disaster Declarations and Staying Connected! Because health centers are in virtually every community in our country, they are in a unique position to respond to COVID-19. Murphy declared both a state of emergency and a public-health emergency on March 9, 2020 as COVID-19 began to spread in New Jersey. Overview To monitor the impact of the COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) conducted extensive data analysis using the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) and is releasing a comprehensive overview of the PHE’s impact on Medicaid and CHIP beneficiaries … The federal government has taken steps to make providing and receiving care through telehealth easier. Most of the states that make up the southeastern United States are rural (Table 1). Yes, there have been significant coverage expansions by both CMS and commercial payers for the duration of the global pandemic emergency, and specifically pursuant to the United States declared public health emergency … National Geographic. Bolin JN, Bellamy GR, Ferdinand AO, Vuong AM, Kash BA, Schulze A, et al. Community health centers play an important role in rural and remote areas and form one of the largest systems of care available to rural populations. J Health Soc Behav 1994;35(4):370–84. 247 d), in response to COVID-19. Health centers also have issues related to the availability of personal protective equipment and testing supplies. This commentary describes the challenges faced by rural communities in addressing COVID-19, with a focus on the issues faced by southeastern US states. Washington (DC): Institute for Women’s Policy Research; 2010. Lack of insurance has implications for access to care, because people without health insurance may delay seeking care even if they have symptoms, for fear of incurring expenses that they cannot pay (16). The impact of such crises is exacerbated in rural racial/ethnic minority communities. https://www.kff.org/medicaid/issue-brief/the-role-of-medicaid-in-rural-america. The United States has adapted its technology and policies to accommodate health care delivery at a distance. For example, to get to Sunflower Medical Center in Ruleville, Mississippi, some patients travel as far as 45 miles to receive care (15). US Census Bureau. North Carolina: Disaster Declaration and Staying Connected!