People in rural parts of the Mountain West are dying from COVID-19 at a higher rate than those in urban areas.
Data from the University of Iowa show that rural death rates across the region rose sharply from mid-October through November. Residents in non-metro areas were dying at twice the rate of those in cities, according to Fred Ullrich, who studies rural health at the university’s Department of Health Management and Policy.
Keith Mueller, head of the department, points to multiple factors. For example, vaccination rates tend to be lower in rural areas. And unvaccinated people who contract COVID-19 are more likely to get severely ill or die from the disease.
Meanwhile, rural residents are often older and have underlying health problems that make them more susceptible to complications from COVID-19.
Other challenges plaguing rural communities, such as food insecurity and poverty, can limit access to healthcare, said Audrey Snyder, former president of the Rural Nurse Organization and an associate dean at University of North Carolina Greensboro's School of Nursing.
“What we know is that with this pandemic, many living in rural environments have not been seeking care for usual things, routine annual physicals or routine care for potential chronic conditions, that we know set them up for being at greater risk,” Snyder said.
Across vast swaths of the American West, residents face long distances to access healthcare. “Another thing we know is that the sooner you are treated and treated with the best available treatment, whether that might be a monoclonal infusion, for example, the greater the chances are that you'll be able to survive, to put it bluntly,” Mueller said.
Still, Mueller is somewhat optimistic about recent research from South Africa showing the omicron variant – now the dominant strain in the U.S. – appears milder than previous iterations of the virus.
“Hopefully we would not see the same kind of disparity in death rates that we do from the delta variant and the beta variant before it,” he said.
But the delta variant is still infecting people. So getting vaccinated and boosted remains one of the best ways people can protect themselves and help give strained rural hospitals a break.
Snyder, for her part, says that strain is particularly disastrous for rural nurses who have been pushed to the brink.
“As a nurse, if you work in an ICU, you get used to seeing death occur. But to see multiple patients in a shift makes it just very overwhelming,” she said. “So the emotional toll for nurses over the past almost two years is significant. And for many of them, they feel very beaten down.”
Snyder said the praise and appreciation that people gave to nurses and other healthcare providers early in the pandemic has waned.
“Now, people are not nice,” she said. There are restrictions on visitors, for example, and nurses “receive the brunt of the lack of understanding and the lack of adherence to guidelines and rules when they're working in these environments.”
Many nurses are now leaving the profession completely.
“They just can't do it anymore,” Snyder said. “They just can't put on their uniform and go into work again to see the same thing happening and to continue to witness deaths that are potentially preventable.”
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Nevada Public Radio, Boise State Public Radio in Idaho, KUNR in Nevada, the O'Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico, with support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.
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