The Southwest Rural Health Research Center https://srhrc.tamhsc.edu at Texas A&M released a study showing that the likelihood of dying from diabetes-related hospitalizations was 3.4 percent higher in rural areas than in large central metropolitan areas between 2009 and 2014.
The Texas A&M University’s Health Science Center report, “Rural Healthy People 2020” https://srhrc.tamhsc.edu/docs/rhp2020-volume-1.pdf updates the current state of rural health priorities and disparities. Several topics are especially related to diabetes.
The report points out that education on self-managing diabetes is not always available, the financial burden of obtaining supplies like insulin, syringes, and oral medication produces a considerable hurdle, rural areas generally do not have the necessary mental health services needed to support the higher rates of depression among rural persons with diabetes, and rural areas are also less likely to have a public transport system to help people obtain medical care.
The concept for using kiosks developed at Texas A&M University has been very successful in disseminating specific recommendations for lifestyle behaviors and helps individuals with diabetes better manage their daily routines.
Health Resources & Services Administration (HRSA) https://www.hrsa.gov within HHS, actively supports diabetes activities in rural communities through their Rural Health Outreach and Network grant programs. Several HRSA grant programs related to telehealth are also available through the Office for the Advancement of Telehealth (https://www.hrsa.gov/rural-health/telehealth.
Several programs in place to help with diabetes in the U.S include the “Vivir Mejor! System of Diabetes Prevention and Care” established to help the population near the U.S Mexican border and the “Heartland Rural Health Network” to help rural residents in Florida.
To further help rural diabetic patients, the “Rural Diabetes Prevention and Management Toolkit” www.ruralhealthinfo.org/tookits/diabetes has been developed. The toolkit provides the resources and best practices to help identify, implement, and help sustain a program to prevent and/or manage diabetes in rural areas.
The toolkit has five modules to help develop programs. Information is available on the Clinical Partnerships Module, Telehealth Module, Community Health Worker Module, School Module, Faith-Based Module, and the Self-Management Module.
The Clinical Partnerships Module deals with several factors that can impede care that includes distances needed to travel for medical care, availability of the workforce to treat patients, insurance coverage available for patients, and how the patient’s literacy levels can affect their medical care.
This module uses a team approach which can involve a range or practitioners such as primary care providers, dietitians, pharmacists, nurses and nurse case managers, community health workers, and volunteers. Non-clinical professionals can also support diabetes education and patient self-management efforts outside of clinical visits. Expanding team support can also improve the quality of care to meet the needs of the community.
The Telehealth Module provides diabetes consultations a distance away, assists with the self-management of diabetes by monitoring blood glucose at a distance, and tailors educational programs online to fit the individual.