COVID & Rural America: Assets & Challenges

This community event was the third in a series of workshops co-sponsored by the US COVID Atlas, a project of the Healthy Regions & Policies Lab (HEROP). The workshops aim to connect with communities disproportionately impacted by the COVID-19 Pandemic, share resources, and discuss how to effectively translate data into action. As such, our third workshop was centered on the impact of COVID-19 on rural communities across the US. If you missed the event, watch the live recording on our YouTube channel.

Keynote speaker, Dr. Rodney Washington (owner and lead strategist at Consulting Plus LLC, and previous professor of health at the Foundation for Mid-South) opened the conversation on how his team adopted and utilized a bidirectional crisis and emergency Risk communication framework from the Mayo Clinic in Minnesota to address attitudes and Misconceptions of COVID-19 among Rural Mississippi Delta Communities. He indicated the importance of community partnership in developing credible messaging that improves preventive behavior in rural communities. This approach, he noted, is particularly important in the Mississippi Delta region, where research is often perceived as extractive without benefiting the community. He emphasized that leveraging the influence of residents in the communities to be the messenger of accurate information not only helps to address questions and generate ideas but is also a useful proxy for other community members to learn of issues/barriers directly from their community members. He also iterated how community and medical mistrust can lead to messages not aligning with mitigating behaviors. Therefore, it is important to craft and deliver messages in a language and modality that are culturally congruent and resonate with residents, especially those residing in historically marginalized communities.

Next, Dr. Kolak (assistant professor at UIUC and PI of the Atlas Project) demonstrated the use of the US COVID Atlas and how it can be utilized to support communities and research works. She noted that although less populated areas might have less infrastructure that impedes travel to either a doctor or access to a hospital, reports highlighting the impact of COVID-19 on these communities in the early days of the pandemic focused mainly on large cities, thereby raising concerns about the fate of rural areas. To address this gap, the US COVID Atlas served as a data visualization and exploration tool that provides access to current and historic health and vaccination data, community context as well as clinics locations, and state-of-the-art spatial methods like spatial statistics to define hotspots and helps to explore the pandemic across rural and urban areas.

Next, four leading health experts led the event’s panel discussion. The facilitator, Sarah Melotte, a geography, and data journalist at Daily Yonder, started the conversation on inequality between rural and urban American spaces. She emphasized how their work revealed over 200,000 rural American residents died of COVID, with a cumulative death rate of 38 percent higher than the metropolitan rate. Laurie Francis, the founder of Co-Op Leadership, recounts some of the complex reasons, such as staffing challenges, difficulty keeping patients safe, and the pushback on vaccines that might have led to a higher death rate in rural America. Dr. William D. Lopez of the university of Michigan highlighted the impact of the COVID-19 on large-scale immigration work sites such as nursing homes, meat packing plants, and prisons and how immigrants’ community relationships with the US government impact how much they trust and access resources such as vaccines.

Further discussion among the panelists revolved around the following questions:

What is one thing you hope history remembers about the pandemic?

We must teach our children about human interaction and how that can help all of us stay healthy and safe. She also emphasized teaching our children about science and what it can and cannot do so that we can stop fighting against the evidence as our understanding of science grows.

We must think about individual behavior change, but more importantly, the racial inequity in terms of structural determinants that impact groups differently- the systems that constrain their ability to make these individuals’ behavior changes happen.

We must adopt a more humanized approach to health services. For example, rural communities do not just see access as just access, but there are some basic things that every household should have, such as internet services and laptops to enhance access to other services. He also emphasized the importance of human dignity and respect in our healthcare system as many households calculate whether it is worth dehumanizing to access some healthcare facilities.

What does a “Social Determinant of Health” mean, and why is it important?

The social determinant of health is a lot of things around us that shape our health. This can be trust, where we live, work, and play, as well as the power privileges and oppressions we see play out daily — who has the power and who is exploiting whom?

How does rurality worsen health outcomes? Does it just build on the impact of racism or compound that risk?

It is not just in the rural space but the attitudes and generational things that develop out of those spaces- how people see their health culturally. This could be their experience with a particular health service or healthcare affordability issues. Other structural factors, such as the location of prisons in our rural spaces, contributed to the spread of COVID infection.

Finally, Mandela Gadri, UIUC Ph.D. student & Atlas team member, highlighted the importance of the COVID Atlas Oral History project and invited everyone to submit a Story about their Pandemic experience through the COVID Atlas page. He also emphasized the various formats (video, audio, written document, photograph/image, or through a phone call)

one can submit to the COVID Atlas page and the right of contributors to take down their story at any time. To qualify, a contributor must reside in the US, be 18 or older, and have previously used or explored the COVID Atlas. The first 50 accepted video submissions will receive a $20 Amazon gift card.

Workshop Resources:

• UndocuHealth Report
• YouTube recording.
• Learn Toolkit, Stories Submission, and Survey at the US COVID Atlas
• Check out more notes and resources from the workshop at our Padlet.

Originally published at http://healthyregions.org on July 11, 2023.