Q&A: New CDC office could help make inroads on work to combat disparities in US rural health ================================================================================================ * Maaisha Osman ![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/53/2/10/F1.medium.gif) [Figure1](http://www.thenationshealth.org/content/53/2/10/F1) People living in rural regions of the U.S. are at higher risk for chronic health issues and unintentional injuries, studies show. A new Office of Rural Health at CDC will help tackle such issues. Photo by SDI Productions, courtesy iStockphoto While the 20% of Americans that live in rural areas face the same major causes of death as others in the U.S. — including heart disease, cancer and unintentional injuries — they are more likely to die prematurely from them than their urban counterparts. The COVID-19 pandemic added to challenges, with rural residents less likely to get vaccinated and more likely to die from the disease. To help address disparities, legislation passed by Congress in December created the Office of Rural Health at the Centers for Disease Control and Prevention. Plans call for the office to develop a rural health strategic plan for CDC and coordinate work across the agency. Among those who supported establishing the new office was the National Rural Health Association, which called it a “massive victory.” *The Nation’s Health* talked to Carrie Cochran-McClain, MPA, the association’s chief policy officer, about the potential impact of the office. ## Why is this new office needed at CDC? We’ve been talking broadly in the rural health community about the need for a voice within all facets of health care to make sure that the rural interest is represented. In the last couple of years with COVID-19, we saw the significant disparities between rural and urban populations, and within rural populations. The rates of folks in rural and urban areas catching COVID-19 were equal, but the morbidity and mortality rates of rural populations were much higher, pointing to a disparity in our health care and public health system. COVID-19 was the momentum for wanting to create a voice within the agency that can speak for the unique challenges that our rural populations face. ## When will the new office be running? What would you like to see come from it? Our goal is to have it running this year. We were able to get funding for the office, which was $5 million appropriated for this year. In terms of what we are hoping they can accomplish: really think about how we can grow the public health workforce in rural communities, and how we can provide technical support and do research around some of the unique challenges that rural populations face. For example, we can tackle some of the unique issues that our local health departments face around maternal health. The maternal mortality and morbidity rates in rural communities are worrisome. ## Why is it important to have this new office at CDC, as opposed to other federal agencies? The COVID-19 pandemic further underscored the structural barriers to addressing healthcare needs in rural communities. Targeted, sustainable resources through a CDC Office of Rural Health are needed to help support rural public health agencies and workers who support their communities. The office will be responsible for the maintenance and enhancement of rural public health infrastructure and for connecting with other parts HHS and the federal government on the potential areas of collaboration. ![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/53/2/10/F2.medium.gif) [Figure2](http://www.thenationshealth.org/content/53/2/10/F2) A woman leans on a gate in Mountain Valley Navajo Tribal Park in Arizona. Legislation passed by Congress in December created a new Office of Rural Health at CDC, which is tasked with developing a rural health strategic plan for the agency. Photo by Grandriver, courtesy iStockphoto ## How will the existing state rural health offices work with the CDC office? There are 50 state offices of rural health that HRSA’s Office of Rural Health Policy funds. They range really significantly. The more we can be collaborating at the federal, state and local levels, the better off we are in terms of information sharing and resource allocation and meeting the needs of the end user in the state and local communities. Rural health is not a smaller version of urban health. It is a microcosm of the set of challenges we face when we think about our larger healthcare system. ## What do you see as the biggest health issues right now for the 66 million Americans who live in rural areas? Some of our top issues are maternal mortality and morbidity. Women who are indigenous, Latina, African American have stark differences in terms of morbidity and mortality. The public health system has a significant role to play in helping pregnant persons throughout that whole cycle of pregnancy, pre- and postpartum. Last year, NRHA started an initiative looking at the role of obesity and other chronic diseases. We’ve been trying to look at some of the drivers around obesity. And then how do we lift up prevention and treatment strategies within rural health care settings. We are looking at older adults in rural areas and thinking about what it takes to keep those populations healthy, whether that’s at home or in a health care setting. ## Where is progress being made on improving health in rural areas of the U.S.? We are looking at various issues, like suicide prevention, given the suicide rates in rural U.S. Making sure people understand what public health is, what it (means) for community. There are a lot of challenges in terms of having an adequate workforce in terms of retaining, supporting and attracting new workers. Rural health care infrastructure is struggling significantly. We are seeing closures of rural hospitals. We are seeing closures of skilled nursing facilities where older adults live. The loss of those types of facilities just kind of exacerbates what those populations are facing. ## If there was one major thing you’d like to see the U.S. do to improve rural health, what would it be? I’m going to go with making sure that we have a robust rural health care workforce and public health workforce. People are our biggest resource in our health care and public health communities. We need to think about how we retain and grow and get our new generation of public health and health care workers to serve rural communities. That’s where I want to see us move the needle first. Then we have a long list behind that. *This interview was edited for style, clarity and length.* * Copyright The Nation’s Health, American Public Health Association