Reducing Rural Care Disparities With Evidence-Based Programs

February 22, 2021 - Rural Americans are at higher risk of a slew of adverse health outcomes. The country’s leading causes of death – heart disease, cancer, and chronic respiratory disease – disproportionately impact rural Americans according to data from the Centers for Disease Control and Prevention.

A lack of sufficient resources, fewer providers, and limited access to high-quality health services are among the leading reasons why rural areas are so vulnerable. 

“Making these environments healthy and promoting healthy policies are very important,” said Victor Sutton, PhD, MPPA, director of the office of preventive health and health equity at the Mississippi Department of Health.

During a recent episode of Healthcare Strategies, an Xtelligent Healthcare Media podcast, Sutton discussed the work his department is doing to address the social determinants of health of residents. These non-clinical risk factors are largely responsible for driving poor health outcomes seen in the state's rural areas.

“We understand that health is tied to education, employment, housing, and transportation. All this stuff can create an environment for healthier outcomes,” Sutton noted. “There are social determinants that come into play.”

The litany of programs Sutton’s office supports stretch a variety of health issues from cardiovascular health and diabetes to injury and violence prevention. The programs aim at building on and creating a new evidence base for effectively addressing social determinants of health.

“One of the things that we’re really excited about is that we’re trying to help build the evidence. There’s been a lot of things that have been replicated across the state and across the nation, but there are also nuances to it,” Sutton explained. “We know that the evidence-based program works in California but may not necessarily work in Mississippi.”

“We're trying to put these everyday evidence-based programs in place, understanding that sometimes things are not as equitable,” he furthered.

Sutton’s office also works to ensure the programs they offer have scalable solutions. Their work emphasizes integrating solutions into policy at a federal, local, or organizational level.

“We have a PSE [policy, systems, and environment] approach. Those systems could be working with mayors, superintendents, service providers, or faith-based organizations,” Sutton elaborated. “It’s a policy systems approach working with evidence-based activities all around creating an environment that allows for optimal health outcomes.”

A large piece of succeeding in this approach requires cross-sector partnerships to promote collaboration and policy-level change.

For example, the Office of Preventive Health and Health Equity is partnering with local health plans to work towards making several of their evidence-based programs reimbursable.

“We understand that there’s a cost to these programs, but when providers are being reimbursed, insurance companies will understand that prevention is the way to go,” Sutton said.

These partnerships did not happen overnight, though. Sutton stressed that it takes time to form productive and collaborative partnerships that work towards preventive care.

“We didn’t get here overnight with some of the numbers that we have in our state. We understand that it’s tied to education, employment, housing, and transportation,” he said. “All this stuff can create an environment for healthier outcomes."

Success stories from these efforts are numerous, including an increase in the number of patients with cholesterol effectively managing their condition, an increase in the number of patients with hypertension adequately controlling their blood pressure, and an increase in smoking cessation promotion.

“We’re one cog working with our partners to improve outcomes and improve the environment so that we can make the healthy choice, the optimal, easy, and affordable choice,” Sutton concluded.