Rural Health: the Dirt Road Less Traveled.

Abstract

The demographic of older adults living in rural areas of the United States is changing. In fact, the most rapidly aging areas in the United States are rural communities, generally defined as having an urban core of <50,000 people.1,2 Of the 56 US counties with the oldest populations, 54 are designated as rural areas.3 Compared with urban populations, rural-dwelling populations have more chronic health conditions, higher rates of disability, and higher fall rates.4 These medical vulnerabilities are compounded by socioeconomic disparities such as lower educational attainment, higher rates of poverty, and lower rates of broadband internet access.5 ... Physical therapy could play a vital role in improving health and physical function for rural-dwelling older adults; however, maintaining staffing within rural facilities has several challenges.6 First, physical therapists may avoid rural practice for a multitude of reasons, including housing, transportation, technology, culture, and educational preparation. Second, there is little evidence to guide preparing students for rural practice or to help rural communities recruit, retain, and support growth of rural physical therapists. Third, therapists seeking professional growth in rural areas may have barriers attending continuing education courses and accessing contemporary research resources or other mentored experiences owing to geographic limitations or technological barriers unique to rural communities (eg, limited broadband internet access). To address these challenges, we will detail contemporary concerns related to education, cultural awareness, and staffing in rural areas. Then, we will outline specific, actionable steps that the profession can take toward ameliorating rural health disparities, including physical therapist didactic and clinical education, supporting lifelong learning for the rural workforce, and advocating for large-scale policy changes to bolster rural physical therapist practice environments.