Rural-urban health disparity and solutions: a global health perspective
18.12.2018
A population that experiences health disparity is one where the health status- disease incidence, prevalence, morbidity and mortality differ significantly compared to the health status of the general population. Rural-urban health disparities are differences in health status between rural and urban regions of a geographic location. It is also called spatial inequality when it involves unequal distribution of resources in space. Globally, rural populations always experience significant health disparities when compared to urban populations, even in the same countries. These disparities are frequently characterized by indicators such as higher incidence of disease and disability, increased mortality rates, lower life expectancies, and higher rates of pain and suffering. Reasons and risk factors for the above indictors are broad and vary from population to population, some of them include geographic isolation, lower socio-economic status, higher rates of health risk behaviors, limited access to healthcare, socioeconomic status, unhealthy behaviors, chronic conditions and limited job opportunities. Research has also shown that residents of rural areas are usually older, poorer, have fewer physicians or resources to cater for them and are less likely to have employer-provided healthcare coverage.
The uneven distribution of healthcare resources between rural and urban areas results from fewer and farther service locations, cultural beliefs, lay understanding of illnesses by patients, reduced funding, limited access to health services, discontinuous education, insufficient health professionals and inadequate mobility in rural areas. Access to health care overall is a challenge to rural residents because they have a lower proportion of the population insured, face greater barriers in traveling to primary, preventative, prenatal, and emergency care providers, and have less diversity in health care resources to choose from. Rural residents are left without or reduced availability of these services, increasing the physical barriers to quality and timely healthcare.
From the preceding paragraphs, it is clear that there has been much progress in understanding rural-urban health disparities; however, some challenges persist. Irrespective of the long history of biomedical treatment of diseases in Africa, culture still informs the understanding and treatment of some chronic and debilitating illnesses such as diabetes, more so in the absence or lack of access to biomedical health facilities. This is a major cause of rural-urban health disparities. Federal, state and non-profit organizations work to reduce these disparities and improve the health and overall well-being of rural residents. Some organizations provide funding, information, and technical assistance to be used at the state, regional, and local level, while others inform state and federal legislators to help improve the understanding of issues affecting population health and healthcare in rural areas. Since 1992, the World Organization of Family Doctors- WONCA has developed specific focus on rural health through the WONCA Working Party on Rural Practice. This Working Party has attracted national and international attention to major rural health issues through World Rural Health Conferences and WONCA Rural Policies. The World Health Organization (WHO) has also formed partnerships to help tackle and solve some rural health challenges. An example is the Memorandum of Agreement between WONCA and WHO which emphasizes the important role of family doctors in primary health care and includes Rural Health Initiative.