Rural America is continuing to get older, and a new report shows the extent has hit a new high.

The U.S. Department of Agriculture’s annual Rural America at a Glance report shows more than 20% of rural residents are over age 65 compared to 16% in urban areas.

“The aging of the baby-boom generation will continue to contribute to the loss of working-age adults through the end of this decade,” the report from the USDA’s Economic Research Service stated.

The report also said there is a corresponding decrease in the working-age population, with those 18 to 64 making up 58% of non-metro residents, compared with 61% of metro residents.

Fixing the problem will take a lot of work from a lot of different areas, said Mary Hendrickson, a professor of rural sociology at the University of Missouri.

“There’s federal issues, there are state issues, there are community issues, there are regional issues. Can we start thinking about regional networks? There really is not just one thing,” she said.

Hendrickson said rural areas need to make things better for families, and that can include such improvements as better broadband access and reliable day care and preschool options, which are not only lacking but often nonexistent in rural areas.

“If we’re going to talk about wanting to be family friendly, then we’re going to need to have some policies that are helpful,” Hendrickson said.

Some rural communities have tried creative ways to attract younger people to make their home away from urban areas, including offering grants to new homeowners and establishing recruiting committees to entice former residents to move back.

“Those kinds of programs are essential,” Henrickson said. “Folks who live in these rural areas sometimes look around and think more of the challenges rather than thinking about what are the opportunities for helping and making their place attractive for a younger generation.”

Other rural advocates caution those kinds of projects won’t be enough and argue for more systemic change at the federal level.

“We learned during COVID that many people can work from anywhere, and that gave a lot of hope to rural communities looking to increase their population,” said Chris Merritt, executive director of the Illinois Institute of Rural Affairs at Western Illinois University.

“But state and federal governments need to get more involved to make sure these communities have health care, schools, transportation and grocery stores. Those things can’t happen at just the community level.”

While rural communities look to increase their younger population, they will also have to deal with new challenges of having more older residents.

“Declines in the working-age population may make it harder to meet labor demands in some rural industries and local labor markets. At the same time, many rural areas lack sufficient health care capacity, broadband service, community centers and other services to address the challenges associated with an aging population,” the USDA report said.

This story was produced in partnership with Harvest Public Media, a collaboration of public media newsrooms in the Midwest. It reports on food systems, agriculture and rural issues. Follow Harvest on Twitter: @HarvestPM.

 The Rural Health Value team recently released a report that describes interviews with five health systems supporting value-based care in their rural affiliates. Interview topics included organizational structure, governance and decision-making, operations, data and communication, contracts, and social determinants of health. The report includes common health system tensions and opportunities as they facilitate rural affiliate success in value-based care. The Rural Health Value team is funded by the Federal Office of Rural Health Policy.

 This new report from the CMS Innovation Center provides an update on the Innovation Center’s progress in the implementation of its new strategy, describes areas of focus for the coming year, and begins the process of measuring progress against the strategy’s five objectives. This update includes a discussion of the Community Health Access and Rural Transformation (CHART Model). A companion supplemental document describes the rationale, methods, and limitations for each of the metrics, baselines, and targets described in this report. The supplemental document includes information on rural innovation models and the inclusion of safety-net providers like Rural Health Clinics (RHCs).

Last month, the Congressional Research Service (CRS), Congress’s nonpartisan research arm, released two reports on 340B. The first report details the conflicting decisions from recent court cases related to 340B contract pharmacies and also give options on how Congress can intervene given the uncertainty with the program. The second report gives an overview of the 340B program as a whole, providing details on program data sales and entity participation, statutory requirements, changes to the 340B statute over time, Government Accountability Office reports and recommendations, and the contract pharmacy litigation. NACHC is actively working on a federal legislative strategy for 2023 to address the instability in the 340B Program. This week’s elections will determine who the key players are in Congress that health centers will need to work with to get 340B legislation passed.

A Research & Policy Brief is available from the Rural Telehealth Research Center:

Sepsis is an expensive disease that is responsible for over 270,000 deaths in the U.S. annually. Early and aggressive treatment with antibiotics and hemodynamic resuscitation have been associated with improved outcomes, but many sepsis patients do not receive guideline-concordant care. Patients treated in low-volume emergency departments (EDs) have 38% higher mortality than those in high-volume EDs suggesting that volume is associated with elements of care that improve survival. Provider-to-provider ED-based telehealth (tele-ED) has been one strategy proposed to improve sepsis care in low-volume EDs. In tele-ED, local ED staff can request consultation with a remote physician and nurse who can connect using a 24-hour on-demand high-definition video connection allowing remote staff to see a patient, review records, provide advice, arrange for inter-hospital transfer, and provide clinical documentation. By connecting a clinician in a high-volume hospital with a care team in a low-volume hospital, rural sepsis patients and providers may benefit from high-volume experience and training even in a local rural facility.

The purpose of this study was to (1) report on the prevalence of tele-ED use for sepsis care across an established network, (2) quantify variation in use between hospitals, and (3) identify predictors of tele-ED consultation in tele-ED-capable hospitals.

This week, the National Council for Mental Wellbeing released a new report highlighting the role of Certified Community Behavioral Health Clinics (CCBHCs) in addressing mental health and substance disorders over the last year. This information features data on CCBHC and FQHC partnerships. Approximately 2.1 million people seek care from CCBHCs around the country.

Across the U.S., a total of 631 rural hospitals — or about 30 percent of all rural hospitals — are at risk of closing in the immediate or near future due to persistent financial losses on patient services, inadequate revenues to cover expenses, and low financial reserves, according to a report from the Center for Healthcare Quality and Payment Reform.

More than 200 of the rural hospitals in the report are identified as being at immediate risk of closure. These hospitals were losing money on patient services before the COVID-19 pandemic, and they did not have sufficient resources to cover those losses, according to the report.   Click here to view the numbers and percentage of rural hospitals by state at risk as of October 2022, based on the Center for Healthcare Quality and Payment Reform analysis.

The Penn State Rural Health Disparities Lab in the Department of Biobehavioral Health has released a report showing rates of employer-sponsored health insurance in rural Pennsylvania. Employer sponsored health insurance (ESHI) is typically subsidized by employers, which can reduce the overall cost for employees. Using data from the American Community Survey, we found that working-age adults living in rural areas in Pennsylvania are less likely to have ESHI than those in urban areas. Across all rural-urban categories, females were least likely to have ESHI. The lower rates in rural areas may reflect fewer job opportunities with established ESHI plans. These findings raise concerns about access to the benefits of ESHI in rural contexts, especially for females. Author: Melanie Dececco, RHO Undergraduate Research Assistant