Reaching Rural Residents: Practical Guidance for State Agencies and Health Plans

Across the United States, nearly 60 million people live in rural areas. These residents represent the backbone of our nation — farmers, small business owners, caregivers, veterans, and families — yet they often face greater challenges in accessing the health care and social supports that urban and suburban communities may take for granted.

Health inequities deepen when geography compounds race, disability, and income disparities. Rural residents deserve the same equity of opportunity in health, housing, and quality of life. The solutions are not abstract; they require listening, investing, and meeting people where they are.

There are key strategies for state agencies and health plans that want to not only reach rural residents, but also partner with them for lasting impact.

1. Understand the Structural Barriers

Rural residents face more than just long drives to the nearest provider. They encounter:

• Workforce shortages in primary care, mental health, and specialty providers.

• Fragile infrastructure, with hospitals closing at alarming rates.

• Transportation gaps, particularly for people with disabilities, seniors, and low-income residents.

• Digital divides, with limited broadband access and digital literacy challenges that make telehealth less accessible.

Recognizing these overlapping barriers is the first step to designing effective interventions.

2. Leverage Local Partnerships

Rural communities thrive on trust. State agencies and health plans cannot succeed if they operate at a distance. Trusted institutions — schools, churches, libraries, food pantries, and local nonprofits — already serve as hubs of community connection.

By partnering with these institutions, health systems can expand their reach. Mobile units, school-based clinics, and pop-up health fairs allow agencies to meet residents where they are, reducing the distance between need and service.

3. Invest in Accessible Technology

Telehealth and digital health tools can close gaps — but only if residents can use them. Agencies must:

• Expand broadband access and affordability.

• Provide technical assistance and training, particularly for older adults and people with disabilities.

• Ensure platforms are accessible to individuals with vision, hearing, and mobility challenges.

Without intentional design, technology risks reinforcing inequities instead of solving them.

4. Co-Create Solutions with Residents

Too often, programs are designed for rural residents instead of with them. Focus groups, community listening sessions, and co-design workshops create opportunities for agencies to learn what residents value most.

Rural families know the unique strengths of their communities — resilience, interdependence, and creativity. Leveraging these insights ensures that strategies reflect lived experience rather than assumptions.

5. Commit to Long-Term Relationships

Rural engagement cannot be transactional or time-limited. Communities remember who shows up consistently — and who disappears when a grant ends. Agencies and health plans that commit for the long haul will be rewarded with trust, loyalty, and improved outcomes.

Moving Forward

Reaching rural residents is not only a policy challenge; it is a matter of equity and dignity. When agencies and health plans design with empathy and inclusion, they do more than close access gaps — they affirm the value of every person, no matter their ZIP code.

As someone who has navigated systems from the vantage point of both consumer and consultant, I believe deeply in the power of inclusive strategies. By bridging voices, building partnerships, and embedding equity, we can ensure rural residents are no longer left behind.