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Rural Americans dying of COVID-19 at higher rate
['Katie Akin', 'More From Author', '- September']
Date: 2021-09-30 00:00:00
Rural Americans died of COVID-19 in mid-September at rates twice as high than the rate of urban Americans, according to a study from the University of Iowa.
The RUPRI Center for Rural Health Policy Analysis has tracked COVID-19 rates in metropolitan and non-metropolitan counties since April 2020. In the second week of September, the Center found that rural areas in the U.S. had COVID a mortality rate of 0.85 people per 100,000. Metropolitan areas had a mortality rate of just 0.41 per 100,000.
The rate of infection was also significantly higher in rural areas, with 66.8 cases per 100,000 compared to 43.3 cases in urban areas.
The surge in rural COVID-19 infections and deaths stands in opposition to the early days of the pandemic, when the virus swept through metropolitan areas. But since then, University of Iowa senior research analyst Fred Ullrich said, the virus has spread just as aggressively — and now, more aggressively — in rural areas.
“Just because you’re in a small area or an isolated area or a rural area does not mean that COVID-19 isn’t going to find your population,” he said.
Alan Morgan, CEO of the National Rural Health Association, said that the reasons behind the disparity are complex. One major factor is vaccination: rural Americans are less likely to be vaccinated, leaving their communities more vulnerable to the virus.
“It’s significantly lower, vaccination rates in rural counties than in urban,” Morgan said.
A September Des Moines Register/Mediacom Iowa Poll found that a quarter of Iowans do not intend to be vaccinated against COVID-19. Rural Iowans were most likely to say they wouldn’t get the vaccine: 36% of Iowans who live outside of towns said they do not plan to get the vaccine.
But rural areas also have demographic and geographic challenges when it comes to COVID-19. Ullrich noted that rural populations tend to be older, poorer and sicker than urban communities.
“It shouldn’t be a horrible surprise to anybody that the reasons that the rate is worse in non-metropolitan areas than it is in metropolitan areas,” Ullrich said.
In addition, people living outside of metropolitan areas may have a harder time accessing medical care. Morgan said that most rural health care centers will transfer patients with serious illnesses to urban hospitals that can provide more intensive care.
“The ICU beds have filled up in urban areas and those patients haven’t been able to be transferred,” Morgan said. “In many cases, critically ill COVID patients have seen an inability to be transferred to ICU appropriate care in urban settings.”
Iowa Department of Public Health data show that the state does still have open ICU beds, but the amount of available space has dwindled. In last year’s November peak, there were consistently over 300 ICU beds available. Now, there are about 160 ICU beds open in the state.
There are currently 157 COVID-19 patients in Iowa ICUs. Of those patients, about 85% are unvaccinated.
Morgan recommended that health organizations and state leaders continue to encourage rural individuals and encourage them to be vaccinated. He said the focus should be on changing “the rural dialogue” — emphasizing the importance of the vaccine to protect communities, rather than imposing federal mandates.
He also said it was important to keep rural hospitals and medical centers staffed as the pandemic continues.
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