Dartmouth Health leads effort to address rural healthcare disparities

By Christopher Cheney

Dartmouth Health has launched an initiative to identify and address rural healthcare disparities in northern New England.

Health equity has emerged as a pressing issue in U.S. healthcare during the coronavirus pandemic. In particular, there have been COVID-19 healthcare disparities for many racial and ethnic groups that have been at higher risk of getting sick and experiencing relatively high mortality rates.

Earlier this month, Lebanon, New Hampshire-based Dartmouth Health inaugurated the Center for Advancing Rural Health Equity (CARHE).

Joanne Conroy, MD, Dartmouth Health president and CEO, said in a prepared statement that CARHE will tackle one of the biggest challenges facing the country's healthcare system.

"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," she said.

People living in rural areas face unique barriers to accessing healthcare and social services, and rural geography makes it hard for health systems and social services to reach everyone who needs care, according to Dartmouth Health.

The planning process for CARHE was concentrated between January and June. Representatives on the planning team included academics, members of community-based organizations, officials from the Vermont Department of Health, and rural residents in New Hampshire and Vermont. CARHE will have four primary approaches to addressing rural healthcare disparities, according to Dartmouth Health:

• Healthcare redesign: Translating knowledge into practice to meet the needs of rural populations
• Research: Community-based research focused on creating evidence to support action
• Community action: Community and health system partnerships crafted to meet local needs
• Education: Training and the sharing of knowledge

The CARHE Leadership Council, the governing body of the center, formed in August. Members of the Leadership Council include clinicians, community leaders, educators, and researchers. The center also has a Community Advisory Council drawn from residents representing diverse populations in rural northern New England.

CARHE will be a collaborative effort, Rudolph Fedrizzi, White River Junction Public Health Services District director and chair of the center's Leadership Council, said in a prepared statement. "We are excited to work together with so many partners to establish the Center for Advancing Rural Health Equity and advance this shared vision for improving the health of our communities in meaningful ways. This collaborative approach, which draws on both expertise and lived experience, is a powerful strategy for improving the lives of all of our friends, family, and neighbors across rural New England."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.