Tag Archives: geography

Skilled Nursing Facilities in Rural Communities: Opportunities for partnering on COVID-19 response efforts

Guest blog post by Dr. Meg Ann Traci, RTC:Rural Knowledge Broker


The devastating and disproportionate rates of novel coronavirus (COVID-19) cases and deaths in institutional settings continues to be part of the national crisis. With data from the 23 states that publicly report data on deaths within long term care facilities, such as nursing homes, skilled nursing facilities and assisted living facilities, the Kaiser Family Foundation estimates more than one in four COVID-19 related deaths in those states (27%) occurred in such settings. The threat within these medical and personal care settings put people with disabilities and others unable to maintain and manage independence in the community, at increased risk. In rural areas, the threat to such institutionalized populations is likely even greater.

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COVID-19: An increased threat to people with disabilities living in rural institutions

Guest blog post by Dr. Meg Ann Traci, RTC:Rural Knowledge Broker.


While rural America is already known to experience higher rates of health disparities than urban, state and local public health data underscore that the current novel coronavirus (COVID-19) pandemic will  continue to harm rural people. COVID-19 is making its way to some of the most rural states of the nation. Just this past week,  Alaska’s Kodiak Island Borough had its first diagnosed case of COVID-19 (April 16, 2020); Wyoming experienced its first fatalities (April 15, 2020); and South Dakota is managing 518 cases identified in a meat processing facility (April 17, 2020).  

Additionally, local and national news headline stories revealed the increased burden of the virus among residents and workers in group quarters such as prisons, nursing homes, and juvenile group homes (non-correctional). The high rates of infection and deaths at a long term care facility in Kirkland, Washington, caught the nation’s attention and refocused the public health response efforts on institutional settings.

Because people living in institutional settings are more likely to report disabilities than the general population and these settings are not evenly distributed between urban and rural areas across the United States, rural people with disabilities have a lot at stake in efforts to address the pandemic and outbreaks in institutional settings.

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RTC: Rural research shows higher risks for rural people during COVID-19

“Not only do you have to travel far to get to beds,” Grieman said, “You’re going to a place where there are more people, where there is also an outbreak, and those beds may also still be in high demand. So, that’s what I find particularly disconcerting.”

RTC:Rural Project Director Lillie Grieman in a recent news article on Public News Service, on why rural people with disabilities are at higher risk during the COVID-19 pandemic.

Rural people with disabilities and barriers to hospital access

Icon of a person in a hospital bed. There is a cross in a map symbol above the bed to symbolize a hospital.
Hospital Bed by Sergey Demushkin from the Noun Project

Rural people with disabilities face many barriers to accessing health care, particularly Intensive Care Units and hospital beds. Hospital capacity varies greatly, as does the prevalence of people with disabilities. Typically, there are fewer hospital beds and higher rates of disability in rural places than urban ones.

Project Director Lillie Greiman discusses some of these barriers in a recent news article- read or listen to the news story through the following link:

Rural Montanans with Disabilities Face Challenges from Home to Hospital

Travis Hoffman, advocacy coordinator for Summit Independent Living, was also interviewed in the article. Summit is a long-time RTC:Rural partner.

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Identifying potential hospital bed shortages for people with disabilities

Recent models from ProPublica, Imperial College, and others predict that millions of people who contract COVID-19 will be hospitalized and many hospitals across the country may not be prepared to treat the influx of patients.

COVID-19 molecule

People with disabilities are particularly vulnerable to impacts from COVID-19, both directly and indirectly. While data about how this virus will impact the health and well-being of people with disabilities is currently limited, people with disabilities are often at greater risk of chronic health conditions, and thus may be more susceptible to infection. People with disabilities also face disruptions in services for daily needs, which could exacerbate conditions unrelated to COVID-19.

Overall, individuals who experience disability are at greater risk for being hospitalized either because they have contracted COVID-19 or because pre-existing health conditions have worsened.


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Recognizing people with disabilities in the COVID-19 pandemic

Understanding the needs of a community is imperative to effectively plan for any type of emergency response, be it natural disaster or a pandemic. As people around the world are dealing with the COVID-19 pandemic, the needs of people with disabilities should not be overlooked or go unaddressed as members of those communities. To assess the impact of COVID on people with disabilities and their needs, it’s important to understand the prevalence of disability by the functional limitations of people living with disabilities experience in their communities.  

According to the American Community Survey, about 41 million, or 13%, of Americans have at least one type of disability (ACS 2015). The vast majority (38 million) live in households with other people and a significant number of people with disabilities live in group quarters, which includes dormitories, nursing homes, and prisons.

Approximately 78 million people without disabilities live in households with a member who experiences a disability. This means that nearly 25% of the US population lives in a household with a member with a disability.

(See Prevalence of Disability: Individual and Household Context for more about this research).

Graphic showing information about the number of households in the US with disability. Full text description in caption.
Graphic from poster presentation “How far do you travel for CIL services?” by Kourtney Johnson, Christiane von Reichert, and Lillie Greiman for the 2017 APRIL conference.
Text description: icon of a green house in a circle with this text: Households in the US = 116,926,305. Same green house in a circle icon with three figures, one using a wheelchair, with this text: Households with disability* = 29,344,352, or 25%. *All households in which at least one person has a disability. There could be one, or more, people with disabilities in each household. There is a box around the graphic, and on top of the frame is a small figure using a walker as a mobility aid.

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Disability Statistics Compendium recordings now available

Christiane von Reichert, Lillie Greiman, and Catherine Ipsen at the 2020 Annual Disability Statistics Compendium event in Washington DC.
Left to right: Christiane von Reichert, Lillie Greiman, and Catherine Ipsen.

On February 11, 2020, RTC:Rural Director Catherine Ipsen and Research Associate Lillie Greiman presented as part of a panel at the Annual Disability Statistics Compendium. Their presentation was titled “Uncovering the intersection of rural and disability.”

Christiane von Reichert, professor of Geography at the University of Montana and a RTC:Rural research partner, was also part of the panel. Her presentation was titled “Using the ACS PUMS to examine disability and migration.”

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Visualizing disability data through maps: RTC:Rural’s state map series

Image of the people with disabilities: Alabama map on top of a background of other maps of Alabama showing different disability data.
Click on the image to view disability maps for the state of Alabama.

RTC:Rural’s Disability in America State Profile Map Series is well underway! We have maps for 17 states posted on the website so far, and more are coming soon. In the next two months general disability maps for every state (for example, Montana and Texas) and Puerto Rico will be complete and available on the RTC:Rural website. Once the general disability rate maps are completed, we will work to produce maps showing different topics for each state. These include:

  • Disability rates among females and males
  • People with vision, cognitive, mobility, self-care, and Independent Living difficulties
  • Veterans with disabilities
  • People with disabilities in poverty
  • Employment, unemployment, and out of labor force rates among people with disabilities
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People with disabilities living in the path of Hurricane Dorian

Map showing the number of people with disabilities (by county) living in the path of Hurricane Dorian. See text for full description.
Map of people with disabilities in the path of Hurricane Dorian. See below for larger, downloadable version and text description.

Understanding the needs of a community is imperative in order to effectively plan for natural disaster emergency response. As Hurricane Dorian heads toward the Florida coast, national, state and local community emergency planners are working to evacuate and shelter thousands of people who are fleeing their homes.

People with disabilities are one of many vulnerable groups especially at risk during natural disasters. In times of emergency, people will evacuate with their households, and will need to shelter with their households. It is not acceptable to separate families and households in times of crisis. Many family members are caregivers, so shelters need to be accessible so that people with disabilities and their families and caregivers can stay together.

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The Return of Map Monday

#MapMonday over a background of colorful maps.Your favorite disability map series has returned!

RTC:Rural is excited to share that we’re relaunching #MapMonday, our weekly map series. Every Monday, we’ll share a new map on our social media channels. Follow RTC:Rural on Facebook, Twitter, or LinkedIn so you don’t miss a map! (But don’t worry if you do miss one—they’re all available on our website).

In the coming weeks, we’ll share maps with overall disability rates, disability rates by difficulty and functional limitation (such as vision, hearing, mobility, and self-care difficulty), veterans, poverty, and employment rates. Continue reading

NIDILRR Research Review showcases importance of federal data in disability research

National Institute on Disability, Independent Living, and Rehabilitation ResearchOn February 22, RTC:Rural Director Dr. Catherine Ipsen participated in the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)’s Administrative Data and Employment Research Review.

“The purpose of the Research Review was to showcase research projects that harness administrative data to improve services for people with disabilities,” Ipsen said. “In addition to representatives from the Rehabilitation Services Administration (RSA), Social Security Administration (SSA), and the Department of Housing and Urban Development (HUD), several researchers described projects that used administrative data to answer and inform research questions.” Continue reading