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ABOUT RURAL HEALTH

• Our nation’s rural and highly rural Veteran

population is large and widely dispersed, 

and is racially, ethnically, and culturally 

diverse.

• About 40 percent of Veterans enrolled

in the VA health care system live in rural 

areas. On average, these Veterans travel 

between 60 to 120 minutes for inpatient 

care, and 30 to 90 minutes for primary care.

• One-third of Iraq and Afghanistan

Veterans live in rural or highly rural areas, 

and three-fourths of rural Veterans are over 

the age of 55. 

• VA’s Office of Rural Health, created in

2007, works to improve access to care 

and quality of care for enrolled rural 

and highly rural Veterans by developing 

evidence-based policies and new practices 

to help enrolled Veterans who live in 

geographically remote areas. 

VA RESEARCH ON RURAL 

HEALTH: OVERVIEW

• VA researchers develop and evaluate new

technologies, interventions, and models of 

care to ensure access to high-quality health 

care for Veterans living in rural areas.

• VA researchers also work to understand

patterns of care among rural Veterans 

and explore ways to partner with non-VA 

providers in areas where VA has no facilities. 

• A Collaborative Research to Enhance and

Advance Transformation and Excellence 

(CREATE) group of VA researchers is 

working with the Office of Rural Health 

to ensure that rural Veterans receive 

adequate levels of mental health care. 

• VA’s Charleston Health Equity and Rural 

Outreach Innovation Center (HEROIC) aims 

to improve health outcomes among rural 

Veterans by examining the increasing role 

of technology on access to care.

SELECTED MILESTONES AND 

MAJOR EVENTS

1995 - VA’s first community-based 

outpatient clinics are established, in part to 

better serve Veterans living in rural areas

2003 – VA’s national home telehealth 

program is implemented

2007 – The Office of Rural Health is 

established

2013 – The Charleston Health Equity and 

Rural Outreach Innovation Center (HEROIC) 

is established

RECENT STUDIES: SELECTED 

HIGHLIGHTS

• Women Veterans living in both rural

and highly rural areas are older and 

more likely to be married than their urban 

counterparts. Generally, the two groups 

have similar levels of several mental health 

disorders, hypertension, and diabetes. 

However, anxiety not related to PTSD is 

significantly lower for highly rural women 

Veterans. (Journal of Rural Health,

Spring 2014)

• A bit of extra help can go a long

way in getting rural Veterans to take 

advantage of VA care and benefits.

Researchers at the Tuscaloosa, Ala., VA 

Medical Center visited local communities 

to let rural Alabama Veterans know about 

the health care services VA offers. Veterans 

who received motivational interviews with 

a social worker, watched an educational 

video, and received a half-hour of 

enrollment support were more likely to 

attend an appointment at the Tuskegee VA 

than those who did not. (Journal of Rural 

Health, Spring 2014)

• HIV and hepatitis C telemedicine

clinics were associated with better 

access to care and high patient 

satisfaction in a study by researchers from 

VA research on 

RURAL HEALTH

Many Veterans who rely on VA for their health care live in 

remote areas—in some cases, hundreds of miles from the 

nearest VA facility. Providing comprehensive, high-quality 

health care to these Veterans is a challenge.

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On average, VA-enrolled rural 

Veterans travel between 60 

to 120 minutes for inpatient 

care, and 30 to 90 minutes for 

primary care.

the VA Greater Los Angeles Healthcare 

System. Another study, by a team at the 

VA Puget Sound Healthcare System, 

found that 3 in 4 Veterans living in the 

Pacific Northwest described themselves 

as either “satisfied” or “highly satisfied” 

with teledermatology for their skin 

problems. (American Journal of Managed 

Care, April 2012; Telemedicine Journal and 

e-health, June 2012)

• Mailing stool tests to Veterans’ 

homes is an effective measure 

for preventing colorectal cancer,

according to researchers at the Iowa 

City VA Health Care System. The findings 

suggest that mailing Veterans screening 

kits, as opposed to waiting to screen 

patients during routine primary care 

visits, may be a more effective method 

to prevent colon cancer, especially for 

rural Veterans. (Journal of Rural Health,

Summer 2014)

• Rural Arkansas Veterans needing 

mental health care have benefited 

from a partnership among 

clergy, representatives of nonprofit 

organizations, Veterans, and mental 

health providers. The approach was 

tested in a study by VA’s Office of Rural 

Health, and found to help Veterans 

who may be uncomfortable contacting 

mental health care providers and prefer 

instead to share problems with VA 

clergy or their church’s pastor. (Progress 

in Community Health Partnerships,

Spring 2014)

• Veterans who live within one mile of 

a large hog farm were more than three 

times as likely as others to test positive 

for a type of bacteria known as MRSA, 

or methicillin-resistant Staphylococcus 

aureus, according to researchers with 

the Iowa City VA Health Care System. 

MRSA infections can quickly become 

deadly because of the bacteria’s 

resistance to common antibiotics. 

(Infection Control and Hospital 

Epidemiology, February 2014)

• VA’s Telemedicine Outreach for PTSD 

(TOP) study involved 265 Veterans 

with PTSD, most living in rural areas.

Specialty teams based at VA medical 

centers partnered with providers at 

community-based outpatient clinics 

to deliver care to Veterans, including 

psychotherapy and medication 

management, via telephone and secure 

video hookups. The study found that 

“telemedicine-based collaborative care 

can successfully engage rural Veterans 

in evidence-based psychotherapy 

to improve PTSD outcomes.” (JAMA 

Psychiatry, Nov. 19, 2014)

• Better communication between VA 

and non-VA providers would improve 

patient safety and satisfaction for rural 

Veterans who use both VA and non-VA 

care, according to a survey of 67 non-VA 

providers. The study was done by a 

team with VA and the University of Iowa. 

(Military Medicine, November 2014)

For more information on VA studies 

on rural health and other key topics 

relating to Veterans’ health, please 

visit www.research.va.gov/topics

RURAL HEALTH 

Updated January 2015 • For a digital version of this fact sheet with active links to sources, visit www.research.va.gov/topics