Structural-Level Determinants of Rural Health Disparities

Health disparities refer to the burden of diseases and other adverse health conditions that exist in populations. Geographic disparities affect various health outcomes, and risk factors for health outcomes, contributing to the prevalence of health disparities observed in non-metro and rural areas. 

In November, the North Carolina Black Alliance engaged with experts at the National Institute of Health’s Rural Health Day. The seminar emphasized the significance of location regarding individuals’ health. Here are a few examples of why place matters for the health of rural communities: 

• The quality of local services varies in metropolitan areas compared to rural areas.
• Individuals are also socialized differently based on their location, which impacts what’s important to them and where they are in analyzing their health. 
• Insurance is often tied to employment, but shifts in the types of employment available in rural areas impact the services they have access to due to transportation or socioeconomic status, making healthcare unaffordable. 

Rurality decreases individual access to health-related resources. Forty percent of people in North Carolina live in one of 80 rural counties. Of these rural counties: 

• 20 counties lack pediatricians 
• 26 counties lack OB-GYNS, with 75 miles or more to travel if you’re pregnant 
• 32 counties lack psychiatrists 
• Only 3% of oncologists are in rural areas 

Health is not just the absence of disease but should consider the entire socioeconomic context. For North Carolinians living in the Black Belt, we must consider historical structures that create present-day barriers to health, exacerbating health issues observed in the Black community.