New Report Urges Expanded Telemedicine for Rural Elderly

The Internet and telemedicine are part of the answer to the disproportionate health risks suffered by California's rural elderly from distance, isolation and lack of clinical services, according to a joint report by Humboldt State University's California Center for Rural Policy (CCRP) and the UCLA Center for Health Policy Research.

The report is titled “The Health Status and Unique Health Challenges of Rural Older Adults in California,” including Humboldt and other isolated counties on the Redwood Coast.

Humboldt State CCRP researchers Melissa Jones, Connie Stewart and Jessica Van Arsdale, MD, co-authored the study, which underlines the benefits of remote medical care. The Internet provides in-home monitoring, patient self-management and online prescription orders. Telemedicine offers diagnostic and a host of other clinical services without regard to distance and location.

However, the report cautions, rural regions such as Humboldt, Del Norte, Mendocino and Trinity Counties do not have enough broadband infrastructure and information technology employees to meet the medical services shortfall. Broadband and info-tech support must be shored up if telemedicine is to meet the high demand.

Of Humboldt County’s population of 15,541 who are age 65 and above, fully 70 percent live in rural locales. Distance, isolation and the lack of services foster high rates of obesity, diabetes, and heart disease.

Diabetes, the report points out, contributes to other serious health problems, including heart and kidney disease, blindness and amputations.

“Our rural elderly-almost one fifth of all older adults in California-experience unique challenges to healthy living,” says Stewart, the CCRP’s Executive Director. “They are less likely to have access to healthy food, reliable transportation, and sidewalks, parks and exercise facilities. And they are up against a shortage of doctors and other primary health care providers.”

Rural older adults are more likely to be overweight and obese, yet consistently unable to afford enough food to last the month. (Rural grocery stores have higher operating costs from low customer volume, decreasing access to nutritious foods). They are more likely to suffer repeated falls and more likely to be blighted by low incomes, which exacerbate health problems.

Given the vicious circle, the Humboldt State/UCLA report endorses multiple strategies:

  • Insurance policies that fully reimburse rural health care providers for use of telemedicine
  • Stronger incentives for primary care providers to serve in rural areas
  • Expanded broadband infrastructure and an adequate information technology workforce
  • ‘Universal design’ houses and other buildings that are constructed with a premium on ease of access
  • Senior ‘walkability’ plans that identify routes that seniors frequently use, with better sidewalks, street lighting and seating/benches
  • Promotion of federal subsidies and other food assistance programs to rural grocery stores and healthy food outlets