stars & disk

Bird & Flags

text

ABOUT RURAL HEALTH

• Veterans are more likely to live in rural

areas than Americans who did not serve in 

the military. While 18 percent of Americans 

live in rural areas, a quarter of Veterans do.

• More than half (57 percent) of rural

Veterans enrolled in VA health care are 65 

years old or older. In addition, 6 percent 

are women; 9 percent report being 

members of racial and ethnic minorities; 

and nearly 435,000 are Veterans of our 

recent conflicts in Iraq and Afghanistan. 

About 44 percent of rural Veterans have 

one or more service-related disabilities.

• Rural Veterans have lower average

household incomes than other Veterans; 

they often face long driving distances to 

access quality health care; and there are 

fewer health care providers and nurses per 

capita in rural areas. 

• VA’s Office of Rural Health (ORH) strives

to eliminate the barriers between rural 

Veterans and the services they have earned 

and deserve, thus improving Veterans’ 

health and well-being by increasing access 

to care.

VA RESEARCH ON RURAL 

HEALTH: OVERVIEW

• In the past 10 to 15 years, VA has

launched a number of initiatives to expand 

and ensure access to high-quality health 

care for Veterans enrolled in the VA health 

care system who live in rural areas. VA 

researchers have been instrumental in 

these efforts by developing and evaluating 

new technologies, interventions, and 

models of care.

• Veterans who live in remote areas of the

country have faced challenges in accessing 

VA care. VA researchers have focused on 

understanding these Veterans’ health care 

needs, and on developing and evaluating 

new initiatives to fill the gaps. Some VA 

studies focus specifically on Veterans in 

rural areas, while others have a broader focus but explore issues or possible solutions 

that are relevant to rural health care.

• With support from the Office of Research

and Development, a Collaborative Research to Enhance and Advance Transformation and Excellence (CREATE) group, 

Improving Rural Veterans’ Access/Engagement in Evidence-Based Healthcare, is 

working with VA’s Office of Rural Health 

to ensure rural Veterans receive adequate 

levels of mental health care.

SELECTED MILESTONES AND 

MAJOR EVENTS

2011 - Published a systematic review of 

rural vs. urban ambulatory (outpatient) 

health care, a reconceptualized model of 

access, and numerous articles on VA access 

to rural health in a special issue of the 

Journal of General Internal Medicine

2013 - Established the Improving Rural 

Veterans’ Access/Engagement in EvidenceBased Healthcare CREATE and several 

centers to research rural health

2013 - Established the Charleston 

Health Equity and Rural Outreach 

Innovation Center (HEROIC) to improve 

health outcomes among rural Veterans 

by examining the increasing role of 

technology in ensuring access.

2014 - Published a study of the population 

demographics and health care needs of 

female rural Veterans enrolled in VA care

2015 - Established the Virtual Specialty 

Care QUERI Program and QUERI for TeamBased Behavioral Health to improve rural 

access to health care through technology

2016 - Established the QUERI-Office of 

Rural Health Partnered Evaluation on 

Healthcare Resource Needs and Program 

Implementation for Rural Veterans

RECENT STUDIES: SELECTED 

HIGHLIGHTS

• Women Veterans living in rural and

highly rural areas were older and more 

likely to be married than their urban 

counterparts, according to a study of the 

population demographics and health care 

VA research on 

RURAL HEALTH

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

Our nation’s rural and highly rural Veteran population is large and 

dispersed. It is also racially, ethnically, and culturally diverse. Providing 

comprehensive, high-quality health care to these Veterans is a challenge.

(Continued on back)

Photo: Hill Street Studios
stars & disk

Bird & Flags

text

VA researchers have been instrumental 

in developing and evaluating new 

technologies, interventions, and models of 

care to help Veterans living in rural areas. 

needs of female rural Veterans enrolled 

in VA care by VA’s Office of Rural Health 

and the University of Colorado. Rural 

and highly rural Veterans were also less 

likely to visit VA for woman-specific 

care than were urban women Veterans. 

Those in highly rural areas were less 

likely to visit for mental health care, 

compared with urban women. (Journal 

of Rural Health, Spring 2014)

• A little extra assistance goes a 

long way in getting rural Veterans 

to take advantage of VA care and 

benefits, according to investigators at 

the Tuscaloosa, Alabama, VA Medical 

Center. The researchers designed 

an outreach initiative that relies on 

motivational interviewing techniques 

and a 20-minute educational video. 

They visited local communities to let 

rural Alabama Veterans know about 

the health care services VA offers. Six 

months after the program ended, 87 

percent of the Veterans who received 

an interview and saw the video had 

attended an appointment at the 

VA, compared with 58 percent of 

Veterans who only received visits from 

investigators. (Journal of Rural Health,

Spring 2014)

• Mailing stool tests to Veterans’ 

homes, instead of waiting for the 

Veterans to be screened during 

office visits, is an effective measure 

for preventing colorectal cancer, 

according to VA Iowa researchers. 

Approximately 1,500 Veterans who 

were overdue for colorectal screening 

were divided into three groups. One 

group received educational material 

in the mail; another was mailed the 

educational material and a fecal 

immunochemical test (FIT), which 

detects human blood in stool. The 

third group received neither the kits 

nor the educational material. Overall, 

21 percent of the total FIT group 

underwent screens within six months 

of the mailing, while only 6 percent of 

each of the other two groups received 

colorectal cancer screens. (Journal of 

Rural Health, Summer 2014)

• Veterans using a videoconferencing 

weight-loss program tended to lose 

more weight than their non-participating peers, according to a 2014 study 

by researchers from the Sioux Falls, 

Iowa, VA Medical Center. The researchers broadcast a series of VA’s MOVE! 

weight-management classes live to 60 

Veterans at community-based outpatient clinics (CBOCs) in South Dakota 

and Iowa, and their weight loss was 

compared to that of a group of Veterans 

who had declined treatment. Participants who attended at least 5 of the 12 

classes lost, on average, 12 pounds more 

than those who did not. Moreover, they 

kept the weight off after a year. (Journal 

of Rural Health, Winter 2014)

• Receiving psychotherapy and 

related services remotely can have 

positive effects on rural Veterans 

with posttraumatic stress disorder 

(PTSD). A study at three VA medical 

centers looked at 266 Veterans, half 

of whom received care at either 

their local CBOC or their nearest VA 

medical center. The other half received 

cognitive processing therapy through 

an interactive video hookup with 

psychologists based at the medical 

center. They also received calls from 

nurse managers and pharmacists and 

had psychiatric consultations via video 

chat. Participants in the telemedicine 

group were much more likely to engage 

in care for their PTSD and showed larger 

decreases in their symptoms. (JAMA 

Psychiatry, January 2015)

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 September 2016 • For a digital version of this fact sheet with active links to sources, visit www.research.va.gov/topics