A bias toward cities and the focus on the health of individuals over populations is exacerbating rural health disparities, according to a research paper published in Health Affairs.
The authors call this bias toward large population centers "structural urbanism." They write that structural urbanism in healthcare is driven largely by the volume-based system, which requires providers to treat more patients to run a viable business, as well as the inefficiencies of remote settings and the focus of public health programs to improve health for the greatest number of people possible.
Overcoming this hurdle to address disparities in healthcare and outcomes for Americans living in rural areas will require structural changes that focus on the health of populations rather than the health of individuals, and reframe population health as a public good.
"If population health is considered a public good, then maintenance of some form of public health and healthcare services is necessary infrastructure for rural America," the authors write. "Conceptualizing rural healthcare as infrastructure, similar to electricity or telecommunications, may provide a path for permanent funding, through whatever mechanisms can be designed."
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