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3 Big Rural, Community Healthcare Challenges

John Commins, for HealthLeaders Media, January 9, 2013

The Obesity Battle in Rural America
Generally speaking, rural providers have to care for an older, sicker, less educated, less-affluent and more overweight population. That poses any number of challenges in this era when reimbursements shift away from fee-for-service and more toward outcomes.

In September, I wrote about a University of Florida study published in the Journal of Rural Health which found that 40% of rural residents are obese, compared with 33% of urban residents.

Earlier studies had already shown that overweight and obesity is a bigger problem in rural areas, but those studies put the difference in the 2% to 3% range. That estimate is now doubled. With about 60 million people live in rural America, and assuming that the UF findings are valid, 24 million rural residents are obese as measured by the Body Mass Index.

"The problem [is that] the earlier studies were based on surveys that asked people to self-report height and weight," UF study author Michael G. Perri told HealthLeaders Media. "The study we did was based on measured heights and weights. One thing we are well aware of is that people tend to underreport their weight and over report their height. Everybody is five to 10 pounds heavier than they report and an inch shorter than they claim."

Obesity is a preventable condition that is linked to any number of serious and expensive-to-treat chronic diseases and other medical conditions such as Type 2 diabetes, coronary heart disease, high-blood pressure, cancer, sleep apnea, osteoarthritis, liver and digestive tract complications, and even mental illness.

"We simply cannot ignore the link between obesity and poverty, and the disproportionate impact this is having on rural America," Alan Morgan, CEO of the National Rural Health Association, said on the advocacy group's Web site. "If we truly want to decrease healthcare costs and improve the nation's health status, we are going to have to start viewing obesity as a top-tier public health concern for rural Americans."

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