A new study from the Center for Global Health Equity at Dartmouth revealed key strengths in the rural Northern New England response that contributed to low infection rates and mitigated the impacts on the region’s vulnerable populations.
The study, COVID-19 and Rural Health Equity in Northern New England: Impacts on Health Equity, analyzes the early phase of the region’s pandemic response. Launched in March as the region braced for a surge of COVID-19 cases, researchers conducted more than 50 interviews with leaders from health systems, social service organizations, and communities across New Hampshire and Vermont. The research sought to understand both the immediate and longer-term impacts of COVID-19 on rural health systems and communities and to define key priorities for action, research, and advocacy in the pandemic response and recovery period.
Despite low numbers of cases in rural areas of the bi-state region, this study revealed significant impacts on rural health systems, vulnerable populations, and communities in New Hampshire and Vermont. The pandemic threatens the stability of already fiscally stressed rural health systems, poses long-term risks to medically and socially vulnerable populations, and may deepen rural poverty. Yet, the research illuminates how the region responded to mitigate these threats.
“Our research highlights that vast disparities in health outcomes are not inevitable. Rural regions faced the triple challenge of limited health systems capacity, high percentage of older and sicker populations, and significant social vulnerability. Yet, rural health systems and communities were able to mount an effective pandemic response and protect their most vulnerable populations.” explained Anne N. Sosin, the program director at the Center for Global Health Equity.
The researchers also found that the robust short-term efforts to protect vulnerable populations have revitalized longstanding efforts to address health equity challenges, including homelessness, behavioral health challenges, and food insecurity.
The research identifies key strengths within the early-stage pandemic response in the bi-state region but highlights the need for strategic investments and policy changes to stabilize the rural health landscape. “There is now a crucial window of opportunity to build upon these strengths to position the region’s rural health systems and communities for long-term recovery,” noted project co-lead Elizabeth A. Carpenter-Song, a research associate professor in the department of anthropology at Dartmouth. As the region faces the continued threat of COVID-19 amid efforts to re-open, sustaining protections for vulnerable populations is paramount.
The strengths the research team has documented in rural Vermont and New Hampshire may hold lessons for other communities facing the challenge of protecting vulnerable populations. “At the heart of the response we found authentic partnerships, organizations that were guided by strong social missions, and the commitment of resources to facilitate swift and effective actions. These factors are not unique to rural areas and can and should be translated to other communities,” said Carpenter-Song.
The researchers describe the full study findings in a recently released report, “COVID-19 and Rural Health Equity in Northern New England: Phase 1 Research Report.” The study team will conduct additional research during summer 2020 to document experiences and emergent challenges as the region re-opens and plans future research to examine the longitudinal impact of the pandemic on rural health equity.