Reimagining America's Rural Health: Challenges and Opportunities.

Objectives: The objective of this inquiry was to identify (a) rural health challenges in the United States, especially in the context of the COVID-19 pandemic and (b) to identify opportunities within the disruptions caused by the pandemic.

Background: Rural healthcare challenges in the United States are not the same as those faced in urban and suburban communities. Nor are rural hospitals a miniature version of larger urban hospitals. Urban healthcare and hospital-centric policies and solutions, hence, do not help address or optimize the unique health challenges of rural communities. Furthermore, the challenges previously faced by rural hospitals were further exacerbated by COVID-19.

Methods: Key points from public deliberations among experts in a 1-day symposium on rural health, attended by 65 professionals representing 18 west Texas institutions, were captured by the authors. The data were subsequently analyzed to identify common areas of information.

Findings: Four clusters of challenges and opportunities were identified: healthcare delivery, healthcare infrastructure/building, community health, and public administration.

Conclusions: Symposium data suggest that rural health faced numerous unique challenges, which were further compounded by the COVID-19 pandemic. However, the pandemic also helped discover the resiliency of clinicians working in rural areas. For rural health optimization, rural health buildings also need to be flexible. While funds are not easily available, some innovative community collaborations with healthcare institutions may generate novel solutions. In the meantime, telemedicine promises a radical change in rural community health services in the future.