Dartmouth Health, in collaboration with community partners, inaugurated the Center for Advancing Rural Health Equity (CARHE),an initiative focused on identifying and addressing persistent health disparities through collaboration, partnership and action.
To mark its launch, the Center convened its first-ever event, “Working Together to Improve Health for Rural New England Communities,” on Nov. 7, bringing people together from across community services, healthcare delivery, research, and education to explore how to catalyze the transformational change needed to eliminate the conditions that create barriers for people in rural New England communities to be as healthy as possible.
“Rural health inequity is one of the most significant, yet largely overlooked, challenges facing our healthcare system today,” says Joanne M. Conroy, Dartmouth Health CEO and president. “We have major challenges delivering—and receiving—healthcare in our rural communities. And we know that amongst our rural populations, there are those who have even greater challenges due to racism, historical marginalization, poverty, and sexual orientation. Through the work of the Center for Advancing Rural Health Equity, we strive to learn with the community what are the causes of unequal health in rural northern New England and to test solutions. The launch of the Center for Advancing Rural Health Equity is a significant step in advancing our mission to tackle these stubborn disparities head-on and ensure that our patients are fully connected to the care they deserve.”
The Center for Advancing Rural Health Equity—which Dartmouth Health claims is among the first centers of its kind in the nation—will be grounded in four pillars of work:
- Healthcare redesign: Translating knowledge into practice to meet the needs of our populations.
- Research: Community-engaged research, creating evidence to inform practice.
- Community action: Community and health system partnerships responsive to local needs.
- Education: Training, learning, and the sharing of knowledge.
“People living in rural communities have worse health outcomes compared to those who live in urban areas. These disparities have existed for a long time but have worsened in recent years. We need a new approach and new solutions. The health system alone will not solve these complex problems,” saysSally A. Kraft, vice president of population health at Dartmouth Health. “The Center for Advancing Rural Health Equity is focused on building strong, collaborative community partnerships, rooted in local knowledge and insights. Together, we will work to develop solutions that allow every individual to be as healthy as possible, regardless of their zip code.”
Rural populations skew older and sicker than those in urban areas and have higher rates of poverty. People living in rural areas face unique barriers to accessing healthcare and social services. Ensuring fair access to health and healthcare for people disproportionately impacted by barriers to care—including Black, Indigenous, and other People of Color, LBGTQ, veterans, immigrants, people living in low-income areas, and others—can be particularly challenging in a rural area, where population numbers are small and widely dispersed throughout a region. Rural geography makes it hard for health systems and social services to reach everyone who needs care.
Rural health equity means that all people living in rural areas are able to live their healthiest life possible. This includes living a life free from discrimination and unfair treatment, as well as having access to healthcare and social services, safe neighborhoods and places to live, reliable transportation, healthy foods, working wages that support basic needs, and community policies that are fair to all people.
A six-month co-design process between January and June 2022 brought together diverse team members to shape the Center. Planning team members were chosen for their expertise, knowledge and willingness to tackle big ideas in pursuit of health for rural populations. Representation on the planning team included individuals from academia, community-based organizations, the Vermont Department of Health, and residents of rural communities in Vermont and NH.