COVID-19 has arrived in rural America. Indeed, the worst outbreaks in October 2020 were in counties with populations less than 50,0001. We knew it was coming2, and yet communities are unprepared to face the significant challenges of caring for COVID-19 patients.
Risks and impacts of COVID-19 are not distributed evenly. This is especially true for people with disabilities and rural residents who face significant challenges to accessing healthcare. For COVID-19, risk increases with advanced age (aged 65 and older), congregate living such as nursing homes and long-term care facilities, and for individuals with several health conditions including asthma, diabetes, blood disorders, serious heart conditions, severe obesity, and for those who are immunocompromised3. Many of these conditions are reported at higher rates among the population of people with disabilities, placing them at higher risk of COVID-19 related complications4.
Social isolation and loneliness are a public health concern because they are associated with poor mental and physical health outcomes and mortality. Social isolation is defined as have few, or no, social connections, and not participating in activities with others. Loneliness is defined as feeling unsatisfied about the amount of social engagement in one’s life.
Before the current pandemic, people with disabilities reported significantly higher rates of social isolation and loneliness than those without disabilities. Inaccessible events and buildings, limited accessible public transportation, social stigma, and lower rates of employment all contribute to these high rates. When restrictions are put in place to help protect people from COVID-19, what happens to these rates?
To learn more about how COVID-19 and public health responses such as stay-at-home orders may contribute to feelings of social isolation and loneliness among people with disabilities, RTC:Rural researchers compared data from two cross-sectional samples collected before and after the first wave of “stay-at-home” orders.
RTC:Rural’s national disability rate maps are featured in a newly published text book “Ethics in Rural Psychology.” The book was written by Dr. Sara Boilen, a psychologist practicing in northwestern Montana, and published by Routledge on Aug. 3.
We emailed Dr. Boilen with a few questions about her new book. The below questions have been lightly edited.
Q & A with Dr. Sara Boilen, author of Ethics in Rural Psychology
RTC:Rural: What is your new book about? Who is it written for?
Dr. Sara Boilen: The book is a tool aimed at mental healthcare professionals in rural areas and students who may someday serve rural Americans. I provide the reader with a general understanding of rural America (and the complexities of rurality) and an overview of some of the relevant cultural factors therein. I then provide a pathway for navigating the tricky ethical landscape commonly found by practitioners serving in insular communities.
Rural/urban differences in trust in sources and preventative practices
Public health is shaped by community-level action. This is especially important during crises such as COVID-19, where widespread adoption of public health practices is necessary to manage community spread and prevent loss. Consistent information is important for fostering trust and adherence to recommended practices.
RTC:Rural’s newest research brief examines how rural people with disabilities use different types of transportation. These include being a driver, asking others for rides, special transportation services, reduced-fare taxis, and public transportation.
People with disabilities, especially in rural areas, still report transportation as a significant barrier to full inclusion and participation in community life, nearly 30 years after the Americans with Disabilities Act was signed into law. Understanding how people with disabilities get around is an important first step for improving transportation options.
Using data from the 2017 National Household Travel Survey, this research brief explores travel behaviors and characteristics of rural and urban people with disabilities.
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.
While many Americans will suffer in the coming recession, people with disabilities in rural areas are especially vulnerable because they are less likely to have an emergency savings fund, have access to paid leave, or be able to work from home.
How has COVID-19 impacted you and your rural community?
RTC:Rural is collecting real stories from real people in rural places who are impacted by the current COVID-19 pandemic.
We want to help shed light on what is actually happening in the lives of people with disabilities from the perspectives of consumers, family members, caregivers and service providers. We feel the uniqueness and complexity of individual stories are important to share. The needs of rural people with disabilities should be considered in efforts to address the impact of COVID-19.
Contact us if you are interested in creating and sharing real stories! Our staff can set up an interview time and format that works well for you. Participants can choose whether or not to remain anonymous in the stories we share together.
Project Director Lillie Greiman and RTC:Rural Director Dr. Catherine Ipsen recently co-authored an article in The Conversation about proposed changes to disability benefits and how those could make it harder for people with disabilities, especially those in rural communities, to maintain federal benefits.