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.
The bulletin shares information about federally-funded resources that can help people with disabilities and older adults, especially those living in rural areas, to remain in their homes and communities. The bulletin shares these resources with state Medicaid agencies, state and local housing agencies, state and local public health agencies, and other health and housing entities.
To help better understand PAS worker experiences, the Rural Personal Assistance Worker Project Team is recruiting PAS workers in Alaska, Arizona, and Montana to take pictures of their daily work experiences.
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.
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.
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.”
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.
RTC:Rural’s previous research has found that people who live in rural areas begin to experience disability from mobility, cognitive and sensory impairment as much as 10 years before people in urban areas. There are also higher rates of disability in rural areas across all age groups. We have also found that racial and ethnic minorities experience the highest disability rates as well as the greatest urban/rural differences.
While some people are born with a disability, most disability is acquired. This can happen suddenly by injury or slowly by chronic disease. Healing, disease course and medical treatment, underlying causes of disability, often fluctuate. This means people do not always report disability consistently over time.
In order to understand urban/rural differences, RTC:Rural is conducting research to understand how disability evolves in rural and urban areas.
Bryce Ward, RTC:Rural Statistician, explains the project and its goals, and gives a quick progress update.
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 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
The passage of the Patient Protection and Affordable Care
Act (ACA) and adoption of Medicaid expansion was associated with substantial
increases in insurance coverage across the United States (see Changes
in coverage and access, MACPAC 2019). However, RTC:Rural
researchers wanted to know how ACA policy changes and Medicaid expansion impacted
people with disabilities, particularly those who live in rural areas.
To explore this question, RTC:Rural researchers analyzed
microdata from the 2008-2013 American Community Survey
Using these data, they were able to compare how insurance coverage has changed
over time for people with and without disabilities in rural and urban places,
and in expansion and non-expansion states.