Deep Dive Into Local Data Shows Diversity of Rural Health Issues in Georgia

Digging into data can help policymakers and healthcare providers understand the challenges facing rural residents in Georgia, according to researchers at a nonprofit healthcare research group. The new study from the Parkland Center for Clinical Innovation digs down to the micro level to look at the health vulnerabilities faced by Georgia’s 663,000 rural residents. The researchers found that rural Georgia residents were more vulnerable to chronic diseases: 93% had high or very high vulnerability to coronary heart disease, and 86% had a high vulnerability to high blood pressure. Other chronic conditions included chronic obstructive pulmonary disease (88%), diabetes (80%), cancer (76%), and mental and behavioral health issues (53%). The PCCI researchers looked at areas considered to be rural census tracts as classified by the U.S. Census Bureau, or areas defined by low population density and housing units. They were able to identify areas where residents were more likely to experience healthcare challenges and present their findings in a hyper-localized way. “What we see is that oftentimes there’s a lot of variation within a ZIP code where things are being averaged at that level, and you’re masking a lot of assumptions about challenges that populations that live within those ZIP codes have,” Dr. Steve Miff, president and CEO of PCCI, said in an interview with the Daily Yonder. “What we found was that there are pockets within (more urban) ZIP codes that had very high vulnerabilities (for healthcare challenges). It’s a really powerful reminder that hyper-localized information is really needed if you’re really going to be able to understand what vulnerabilities rural or urban areas face in a way that’s really useful.” When looking at the rural census tracts, the researchers analyzed 26 indicators of health from the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. By applying risk factors that can influence an individual’s health, the analysts were able to identify whether residents in a certain census tract were more vulnerable to certain diseases and other healthcare challenges. The research found that those residents face significant challenges when it comes to their healthcare infrastructure. Since 2010, nine rural hospitals in Georgia have closed – one of the highest rates of closure in the nation. An estimated 25 of the state’s remaining rural hospitals are at risk of closure. Those closures raise concerns about residents’ ability to access healthcare services. The state’s rural residents also face socioeconomic barriers such as low education attainment, food insecurity, low levels of health insurance coverage, lack of access to transportation, and poor internet access. That contrasts sharply with Texas, another state researched by PCCI, Miff said. In that state, healthcare challenges were marked by the distance to hospitals. Seventy-four counties in Texas have no hospital, the study found, and as of 2024, one in five rural Texas counties did not have a licensed primary care physician. On average, rural residents travel about 59 miles to reach referral centers, and in parts of West Texas, the travel distance exceeded 100 miles, the study found. That lack of access to care, combined with a lack of internet connectivity, contributed to rural Texas’s high vulnerability to chronic diseases. The researchers found that 88% of rural Texans had a high or very high vulnerability for chronic heart disease, and 85% had a high or very high vulnerability for cancer; 87% had a high or very high vulnerability for high blood pressure. Not only were the conditions more prevalent in rural communities, the study found, but they also contributed to a significantly higher age-adjusted mortality rate. The two studies also found differences in what works in those states’ rural areas. In Georgia, many of the rural areas studied benefited from strong social cohesion, informal caregiving networks, and a deep sense of community identity, all of which, researchers said, contribute to resilience and collective problem solving. “Trusted relationships between residents and local institutions, including clinicians, public health departments, faith-based organizations, and community leaders, often play a central role in how health information is shared, and services are delivered,” the study found. “Leveraging the capabilities of regional systems to provide coordinated referral pathways, telehealth collaboration, and knowledge-sharing can further expand these networks of trust and help healthcare initiatives reach populations that might otherwise remain disconnected from preventive services or ongoing care.” “The strengths inherent in our rural communities combined with data-guided outreach strategies can serve as a force multiplier in moving from crisis care to proactive, preventive care,” Ted Shaw, former CEO of the Texas Hospital Association, said in a statement. “When we use tools like the Community Vulnerability Compass to identify needs early and connect people to care through telehealth and trusted local partners, we can deliver care that is timely, relevant, and accessible and significantly move the needle in improving the health and well-being of rural Texans.” What the research proves, Miff said, is that all rural communities are not alike. “One-size-fits-all solutions simply don’t work in rural health, and our data proves it. What fixes a crisis in Texas can fail in Georgia,” he said. “If we want to make a meaningful impact, we have to get hyper-local and data-driven, tailoring each intervention to the community’s unique needs instead of imposing urban playbooks or generic plans. It’s time to ditch the one-size-fits-all approach and design rural health solutions as unique, diverse, and resilient as the communities they serve.”