Researchers at the University of Iowa analyzed COVID-19 death data in rural and metropolitan counties and found that rural Americans have died at twice the rate as those living in more urbanized counties. The health divide will only widen.
When the novel coronavirus first surfaced in the New York metropolitan area in March 2020 and became the global epicenter of the pandemic, cities, particularly dense ones, were linked intrinsically to infections. But health experts knew it was a matter of time before the virus would hit America's rural heartland.
"The virus not only doesn't respect national or state borders, but it also doesn't limit itself to just cities," said Dr. Ashish Jha, then-director of the Harvard Global Health Institute. [Cited from the related post, "Will the Coronavirus Spare Rural America? April 13, 2020].
"Obviously suburbs and rural areas are less dense, and that doesn't mean that the virus isn't coming, it just means it's going to come a little later, and that it's going to spread a bit more slowly."
Referring to the rural areas, that time came last fall, initially in the Midwest, particularly North Dakota, but would eventually overtake most of the nation in both metro and no-nmetro areas during the deadly winter surge.
Rural Policy Research Institute
It released its initial white paper on March 26, 2020, a week after California Gov. Gavin Newsom issued the nation's first stay-at-home order to mitigate the spread of the coronavirus. The white paper launched a series of weekly data briefs to track the "nonmetropolitan and metropolitan spread of the disease."
Rural Americans are dying of covid at more than twice the rate of their urban counterparts — a divide that health experts say is likely to widen as access to medical care shrinks for a population that tends to be older, sicker, heavier, poorer and less vaccinated.
Since the pandemic began, about 1 in 434 rural Americans have died of covid, compared with roughly 1 in 513 urban Americans, the institute’s data shows. And though vaccines have reduced overall covid death rates since the winter peak, rural mortality rates are now more than double urban rates — and accelerating quickly.
Part of the problem is that covid incidence rates in September were roughly 54% higher in rural areas than elsewhere, said Fred Ullrich, a University of Iowa College of Public Health research analyst who co-authored the institute’s report. He said the analysis compared the rates of nonmetropolitan, or rural, areas and metropolitan, or urban, areas. In 39 states, he added, rural counties had higher rates of covid than their urban counterparts.
COVID Kill Boxes
“There is a national disconnect between perception and reality when it comes to covid in rural America,” said Alan Morgan, head of the National Rural Health Association. “We’ve turned many rural communities into kill boxes. And there's no movement towards addressing what we're seeing in many of these communities, either among the public or among governing officials.”
Rural/Urban Vaccination Rates
Weber also reports on the analysis of vaccination rates in metro and non-metro counties by The Daily Yonder, a digital news website published by the nonprofit, nonpartisan Center for Rural Strategies. Lower vaccination rates in rural counties make residents vulnerable to worse health outcomes than their urban counterparts and likely increases transmission rates.
In metropolitan counties, 54.0% of the population is fully vaccinated. The gap between the rural and metropolitan vaccination rates remained steady at about 11.8 percentage points.
In the table titled, "Vaccination Rates as of September 30," all but four states (Massachusetts, Arizona, New Hampshire, and Alaska) among the 47 states with metropolitan and non-metropolitan counties had higher percentages of fully vaccinated residents in metropolitan counties.
Weber reports on the other factors affecting access to health care in rural areas.
[S]ince 2005, 181 rural hospitals have closed. A 2020 Kaiser Health News analysis found that more than half of U.S. counties, many of them largely rural, don’t have a hospital with intensive care unit beds.
Another factor is nursing shortages which ironically may be exacerbated by the Biden administration's new vaccine mandates that apply to health care facilities that receive Medicare and Medicaid reimbursement. Weber cites one rural hospital in northeasternTexas where the vaccination level among staff is 50%, though it's 13 points higher than the county.
Related in Planetizen:
- Vaccination Disparities Between Urban and Rural America, May 25, 2021
- Density Takes Center Stage in the Pandemic, Again, January 7, 2021
- Does Density Aggravate the COVID-19 Pandemic? Early Findings and Lessons for Planners, July 2, 2020
- Will the Coronavirus Spare Rural America? April 13, 2020
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Tufts University Department of Urban and Environmental Policy and Planning
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Colorado Department of Local Affairs
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Watafiti wa Chuo Kikuu cha Iowa walichambua data ya vifo vya COVID-19 katika kaunti za vijijini na za mji mkuu na kugundua kuwa Wamarekani wa vijijini wamekufa kwa kiwango cha mara mbili kuliko wale wanaoishi katika kaunti za mijini. Tofauti ya afya itazidi kuongezeka. Wakati virusi vya corona vilipotokea kwa mara ya kwanza katika eneo la mji mkuu wa New York mnamo Machi 2020 na kuwa kitovu cha janga hilo ulimwenguni, miji, haswa yenye watu wengi, ilihusishwa na maambukizi. Wataalamu wa afya wanasema ni suala la muda kabla ya virusi hivyo kuenea katika maeneo ya mashambani. "Hii sio tu kwamba virusi haviheshimu mipaka ya kitaifa au ya serikali, lakini pia haijipunguzii miji tu, ""alisema Daktari Ashish Jha, mkurugenzi wa Taasisi ya Afya ya Ulimwenguni ya Harvard." [Kichwa kutoka chapisho linalohusiana, "Je, Coronavirus itaokoa Amerika ya Vijijini? Aprili 13, 2020]. "Kwa kweli, maeneo ya mashambani na mashambani yana idadi ndogo ya watu, na hiyo haimaanishi kwamba virusi havijaja, inamaanisha tu kwamba itakuja baadaye kidogo, na kwamba itaenea polepole zaidi. """ Kwa upande wa maeneo ya mashambani, wakati huo ulikuja vuli iliyopita, mwanzoni katika Midwest, haswa North Dakota, lakini hatimaye ingezidi nchi nzima katika maeneo ya metro na maeneo yasiyo ya metro wakati wa kuongezeka kwa majira ya baridi kali. Taasisi ya Utafiti wa Sera ya Vijijini ilitoa karatasi yake nyeupe ya awali mnamo Machi 26, 2020, wiki moja baada ya Gavana wa California. Gavin Newsom ametoa amri ya kwanza ya kukaa nyumbani nchini ili kupunguza kuenea kwa virusi vya corona. Karatasi nyeupe ilizindua mfululizo wa taarifa za kila wiki za data kufuatilia "kuenea kwa ugonjwa huo katika maeneo yasiyo ya mijini na mijini". Wamarekani wa vijijini wanakufa kutokana na COVID-19 kwa kiwango cha mara mbili zaidi ya wenzao wa mijini - mgawanyiko ambao wataalam wa afya wanasema unatarajiwa kupanuka wakati upatikanaji wa huduma za matibabu unapopungua kwa idadi ya watu ambao huwa wazee, wagonjwa, wazito, maskini na waliopigwa chanjo kidogo. Tangu kuanza kwa janga hilo, karibu 1 kati ya 434 ya Wamarekani wa vijijini wamekufa kutokana na COVID-19, ikilinganishwa na karibu 1 kati ya 513 wa Wamarekani wa mijini, data ya taasisi hiyo inaonyesha. Na ingawa chanjo zimepunguza viwango vya jumla vya vifo vya covid tangu kilele cha majira ya baridi, viwango vya vifo vya vijijini sasa ni zaidi ya mara mbili ya viwango vya mijini <unk> na kuharakisha haraka. "Sehemu ya tatizo ni kwamba viwango vya maambukizi ya COVID-19 mnamo Septemba vilikuwa karibu 54% zaidi katika maeneo ya vijijini kuliko mahali pengine, ""alisema Fred Ullrich, mchambuzi wa utafiti wa Chuo Kikuu cha Iowa cha Afya ya Umma, ambaye alishiriki kuandika ripoti ya taasisi hiyo." Alisema uchambuzi huo ulilinganisha viwango vya maeneo yasiyo ya mji mkuu, au ya vijijini, na maeneo ya mji mkuu, au ya mijini. Katika majimbo 39 ya Marekani, kaunti za vijijini zina viwango vya juu vya COVID-19 kuliko zile za mijini. "Kuna kutoelewana kwa kitaifa kati ya utambuzi na ukweli linapokuja suala la COVID katika vijijini vya Amerika, ""Alman Morgan, mkuu wa Chama cha Kitaifa cha Afya ya Vijijini, alisema." <unk>Tumegeuza jamii nyingi za vijijini kuwa masanduku ya kuua. "Hakuna hatua yoyote inayochukuliwa dhidi ya kile tunachokiona katika jamii hizi, ama kati ya umma au kati ya maafisa wa serikali. ""Vipimo vya chanjo za vijijini na mijini"" Weber pia inaripoti juu ya uchambuzi wa viwango vya chanjo katika kaunti za metro na zisizo za metro na The Daily Yonder, tovuti ya habari ya dijiti iliyochapishwa na Center for Rural Strategies." Viwango vya chini vya chanjo katika wilaya za vijijini hufanya wakazi waweze kuathiriwa na matokeo mabaya ya afya kuliko wenzao wa mijini na uwezekano wa kuongeza viwango vya maambukizi. Katika wilaya za mji mkuu, 54.0% ya idadi ya watu wamepewa chanjo kamili. Tofauti kati ya viwango vya chanjo ya vijijini na ya mji mkuu ilibaki imara kwa karibu asilimia 11.8. "Katika jedwali lililoitwa ""Viwango vya chanjo hadi Septemba 30,"" majimbo yote isipokuwa manne (Massachusetts, Arizona, New Hampshire, na Alaska) kati ya majimbo 47 na kaunti za mji mkuu na zisizo za mji mkuu yalikuwa na asilimia kubwa ya wakazi waliopatiwa chanjo kamili katika kaunti za mji mkuu." Weber anaripoti juu ya mambo mengine yanayoathiri upatikanaji wa huduma za afya katika maeneo ya vijijini. Tangu mwaka 2005, hospitali 181 za vijijini zimefungwa. Uchambuzi wa Kaiser Health News uligundua kuwa zaidi ya nusu ya kaunti za Marekani, nyingi kati yao ni vijijini, hazina hospitali na vitanda vya kitengo cha huduma za dharura. "Kuna uwezekano wa kuwa na upungufu wa wauguzi ambao, kwa kushangaza, unaweza kuongezeka na amri mpya za chanjo za utawala wa Biden ambazo zinatumika kwa vituo vya huduma za afya vinavyopokea malipo ya Medicare na Medicaid. """ "Weber alitaja hospitali moja ya mashambani kaskazini mashariki mwa Texas ambapo kiwango cha chanjo kati ya wafanyakazi ni 50%, ingawa ni pointi 13 juu kuliko kaunti.""" "Kutokana na ""Mipaka ya chanjo kati ya miji na vijijini Amerika"" (Mei 25, 2021) na ""Density inachukua hatua ya katikati katika janga hilo"" (Januri 7, 2021) - Je, msongamano wa chanjo unaongeza janga la COVID-19?" Matokeo ya mapema na masomo kwa wapangaji, Julai 2, 2020 - Je, Coronavirus itaokoa Amerika ya Vijijini? Indiana: Sheria iliyopendekezwa itaathiri ujenzi wa IndyGo Blue Line, awamu ya tatu ya mfumo wa usafiri wa haraka wa basi la jiji LA's 'Spongy' Infrastructure Captured Almost 9 Billion Gallons of Water Jiji linageuka mbali na mazoea ya usimamizi wa maji ya mvua ambayo husafirisha maji baharini, kujenga miundombinu ambayo hukusanya na kuelekeza chini ya ardhi badala yake. "Wekezaji wakipata idadi kubwa ya nyumba za bei nafuu, viwango vya juu vya riba na bei za juu zaidi zinawaongoza wawekezaji kuzingatia nyumba katika kiwango cha chini cha bei, na kuongeza upungufu wa hifadhi na kushinikiza wanunuzi wa kawaida wa nyumba nje ya soko. """ Mpango wa Uongozi wa Ofisi ya Shirikisho: Mpango wa Uongozi wa Ofisi ya Shirikisho: Mpango wa Uongozi wa Ofisi ya Shirikisho: Mpango wa Uongozi wa Ofisi ya Shirikisho: Mpango wa Uongozi wa Ofisi ya Shirikisho Jinsi ya kuhifadhi maji ya mvua inaweza kufanya miji salama zaidi, miundombinu ya kijani inaweza kusaidia kuzuia mafuriko na kujaza vifaa vya maji ya chini ya ardhi, kuzuia kuanguka ambayo hufanya ardhi kuzama. Boston Blue Hill Avenue ni moja ya barabara kuu za Boston ambazo zinatumika kwa zaidi ya abiria 37,000 kila siku. Chuo Kikuu cha Tufts, Idara ya Sera ya Miji na Mazingira na Mipango, Jiji la Grand Forks, North Dakota, Ofisi ya Maendeleo ya Sera na Utafiti ya HUD, Jiji la Birmingham, Alabama, Jiji la Laramie, Wyoming, Idara ya Masuala ya Mitaa ya Colorado, Mfululizo huu wa kozi sita unachunguza dhana muhimu za muundo wa mijini kwa kutumia programu ya chanzo wazi na kuwapa wapangaji vifaa wanavyohitaji kushiriki kikamilifu katika mchakato wa muundo wa mijini.