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High cost and declining quality are plaguing health care in the United States. While this is a national issue, the challenges facing individuals in rural communities are especially complex. According to the Centers for Disease Control and Prevention (CDC), more than 46 million Americans—roughly 15% of the US population—live in rural areas, as defined by the United States Census Bureau.1 (Its definition is based largely on population density.) Health care disparities for this segment of the population are well-documented, and health care organizations and providers in rural areas face unique challenges.

For example, although specialization is a cornerstone of success in many health care reform models, providers in rural communities must have a broad and diverse knowledge base and be exceptional generalists. Rural health care providers may need to travel long distances to bring their services to individuals who otherwise have little or no access to health services. Additionally, while technology offers potential solutions to issues related to access and ongoing patient engagement and support, many rural communities and providers have limited access to this technology.

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  1. Centers for Disease Control and Prevention. About Rural Health. Accessed March 16, 2018.
  2. Institute of Medicine Committee on Monitoring Access to Personal Health Care Services. Millman M (ed). Access to Health Care in America. Washington, DC: National Academies Press; 1993.
  3. National Healthcare Quality Report, 2013 [Internet]. Chapter 10: Access to Healthcare. Rockville, MD: Agency for Healthcare Research and Quality; 2014. Accessed March 16, 2018.
  4. Croft JB, Wheaten AG, Liu Y, et al. Urban-rural county and state differences in chronic obstructive pulmonary disease, United States, 2015. MMWR Wlky Rep. 2018;67(7):204-211.
  5. PTNow. Chronic Obstructive Pulmonary Disease (COPD). Accessed March 16, 2018.
  6. Centers for Disease Control and Prevention. Public Health Matters Blog: Rural America in Crisis: The Changing Opioid Overdose Epidemic. Accessed March 16, 2018.
  7. Rogers LQ, Markwell SJ, Courneya KS, et al. Exercise preference patterns, resources, and environment among rural breast cancer survivors. J Rural Health. 2009;25(4):388-391.
  8. McManus BM, Lindrooth R, Ricardson Z, Rapport MJ. Urban/rural differences in therapy service use among Medicaid children aged 0-3 with developmental conditions in Colorado. Acad Pediatr. 2016;16(4):358-365.
  9. Danzl MM, Harrison A, Hunter EG, et al. "A lot of things passed me by": rural stroke survivors' and caregivers' experience of receiving education from health care providers. J Rural Health. 2016;32(1):13-24.

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