What led you to focus on the health of people living in rural areas of the country?

While I grew up a city kid, my father was from rural Indiana, and I spent my teenage summers working at a camp where most of the staff were from small towns. This exposed me to the stark differences between my life in Kansas City and my friends’ experiences in small rural towns. While pursuing my Ph.D., I developed an interest in studying the relationship between the natural environment, population health and the well-being of our rural populations.

How dire is the situation in Kansas when it comes to the health and well-being of rural residents?

Many rural hospitals in Kansas are at risk of closing, and access to many forms of care is limited. That said, there are a great many people working on these issues in innovative and exciting ways. The Masonic Cancer Alliance is expanding access to cancer detection and clinical trials, the University of Kansas Alzheimer’s Disease Research Center is working on expanding rural brain health, and groups like HOSA–Future Health Professionals are working to grow the rural Kansas health care workforce from within.

I think a lot of people probably believe that people in rural areas are healthier than their counterparts living in urban areas. Is that accurate?

Generally, this is a fallacy. Rural areas have seen decades of persistent outmigration, particularly of young people. As a result, mortality is higher in rural areas simply due to having more people at ages where death is more common. But rural areas generally have worse health outcomes across all groups due to lower access to preventive care, different attitudes surrounding health behaviors, the local food environment, environmental exposures to hazardous materials, occupational hazards and the health impacts of poverty and financial hardships.

Many people may also labor under the misconception that rural areas are less affected by the conditions caused by changes in the environment.

Rural communities are some of the most heavily and earliest impacted. While fewer rural adults work in agriculture and natural resources today, they are still anchors of rural economies. The extreme weather patterns and wildfires not only decimate crops, impact yield and seriously threaten economic activity — but also present serious health risks to rural communities.

What about water quality in rural areas?

Water pollution represents a major problem for rural areas. Domestic private wells are not regulated by the federal government, so we have no idea about the quality of the water many rural Americans drink. Also, many agricultural activities are not subject to the Clean Water Act, which means that the water in rural areas can have unsafe levels of herbicides, pesticides, nitrates and heavy metals.

Can you tell us more about the Kansas Center for Rural Health and its mission?

The Kansas Center for Rural Health aims to identify and reduce rural health disparities and improve rural health care workforce and care delivery through research, education and service. Our education and service focus on growing and sustaining the rural health care workforce in Kansas. We are also committed to spotlighting and growing responsible rural research that genuinely helps rural communities and hospitals. We want to support the development of trusting relationships between researchers, rural doctors and their patients.

What are the center’s primary goals over the next several years?

This year we are launching a new speaker series that brings KU Medical Center researchers and innovative practitioners from across the state to communicate the realities and opportunities of rural practice. We are also working on a new series of research briefs that will help disseminate findings from our research to the public in a plain-language format.

Are there particular populations in rural areas of Kansas more likely to experience poor health and quality of life?

The same marginalized groups that struggle in urban areas also struggle in rural areas. The two groups with the poorest outcomes in rural Kansas are Native American and Black populations, who struggle due to a number of structural and systemic issues. Further, although rural Latino populations generally have better mortality outcomes than their non-Latino white counterparts, there are many unique challenges these populations and their children face due to language barriers, discriminatory practices and difficulty accessing social services and the health care system.

One of the issues frequently cited when it comes to the health of rural residents is inadequate access to healthy food. Can you talk about that problem and whether there are any solutions to food deserts?

Although rural areas are known for growing our produce and protein, this is often paired with limited local access to these products. For example, many rural areas do not have a grocery store within a short distance. As a result, the food options end up being fast food or products you can find at convenience stores. This doesn’t allow for many healthy choices. Possible solutions could include state-supported transportation to grocery stores for those who cannot drive, produce delivery options, local community gardens or farm-to-school initiatives.

What entities is the Center for Rural Health collaborating with to ensure more rural Kansans have access to quality affordable health care?

Within KU Medical Center, we have partnered with faculty and staff from many departments and offices over the past year. Externally, we are supporting events and programs from the Rural Cancer Institute, HOSA–Future Health Professionals, the Masonic Cancer Alliance and rural hospitals across the state, among others.