This blog post was prepared by RNO Website Committee Chair Joan Grant Keltner.
Unsurprisingly, in a national study comparing pediatric hospitalizations in urban and rural areas over the last 10 years, researchers reported hospitalizations decreased overall, including those hospitals serving only pediatric populations (Leyenaar et al., 2023). However, inpatient beds in rural areas declined at a steeper rate than their urban counterparts, 26.1% vs 10.0%, respectively (Cushing, 2021). Births in rural hospitals also decreased by about 25%, with an almost 4-fold decrease in non-birth pediatric hospitalizations, with more admissions for children with disabilities, mental health diagnoses, and multi-faceted chronic illnesses (Leyenaar et al., 2023). Unfortunately, these statistics regarding declining inpatient units and diagnoses/illnesses demand rural parents drive much longer distances to receive medical care for their children.
These dramatic rural statistics/facts suggest the urgent need to:
- Develop state and healthcare system clinical and policy changes to provide primary and specialized medical care to children in rural communities.
- Offer integrated services through telehealth and telemedicine in primary care and schools.
- Provide early learning programs to address affordable physical and psychological, and behavioral health care resources to children and their families.
- Develop policies and programs to alleviate fiscal difficulties in obtaining these resources.
- Provide support for neighborhoods that provide community, social, and recreational resources to allow these children to play, read, and socialize.
- Design school, home, and community environments that integrate child and family quality nutrition and physical activity as a part of daily life (CDC, 2023).
- Offer services in rural schools, primary care, and communities, teaching about injury prevention, routine vaccinations, stressful life events, obesity/healthy weights and living activities, accident prevention, and disability and risk factors, such as smoking, illicit drug use, etc. (Centers for Disease Control and Prevention [CDC], 2016; 2023).
CDC. (2016). Disability and risk factors. https://www.cdc.gov/nchs/fastats/disability-and-risk-factors.htm
CDC. (2023). Working together, we can help children in rural communities thrive. https://www.cdc.gov/childrensmentalhealth/features/rural-health.html
Cushing, A. M., Bucholz, E. M., Chien, A. T., Rauch D. A., & Michelson, K. A. (2021). Availability of pediatric inpatient services in the United States. Pediatrics, 148(1), e2020041723. https://doi.org/10.1542/peds.2020-041723
Leyenaar, J. K., Freyleue, S. D., Arakelyan, M., Goodman, D. C., & O’Malley, A. J. (2023). Pediatric hospitalizations at rural and urban teaching and nonteaching hospitals in the US, 2009-2019. JAMA Network Open. 2023;6(9), e2331807. https://doi.org/10.1001/jamanetworkopen.2023.31807
