June 2020 Research


COVID-19 & Rural Health Equity in Northern New England

The Phase I Research Report is available at this link.

The HERE Initiative emphasizes community-based research, leveraging the expertise and resources of academic and health system partners to respond to the needs and priorities of rural communities. A primary mission of HERE is to build capacity for community-responsive research across the coalition to create an infrastructure to promote systematic learning from diverse stakeholders to inform feasible and relevant strategies to address rural health equity challenges.

HERE researchers are currently examining the impact of the COVID-19 pandemic on rural health equity in Vermont and New Hampshire. Vermont and New Hampshire have registered very low numbers of COVID-19 cases thus far despite bordering two states with the largest outbreaks. This study has revealed significant strengths within health systems, social service organizations, and communities across both states that contributed to low rates of infection, facilitated a robust health system response by rural institutions, and mitigated the worst impacts of the pandemic on the region’s most vulnerable populations. Importantly, this study demonstrates that poor outcomes for vulnerable populations are not inevitable: small, resource-constrained rural institutions were able to mobilize public health and health systems responses that prioritized vulnerable populations.

Despite the low case numbers, the pandemic has had significant financial and operational impacts on healthcare organizations. This study highlights the urgent need for strategic support to temper the devastating financial and social impacts of the crisis. Left unsupported, the pandemic threatens the stability of already fiscally stressed rural health systems and communities. The pandemic also threatens to deepen rural poverty and decimate smaller institutions. Strategic investments are necessary to mitigate the broader impacts on well-being and position rural communities to leverage new opportunities for rural renewal. Our study focuses on five key areas: pandemic response, vulnerable patients and populations, telehealth as a tool for health equity, health systems impacts, and broader impacts on health and wellbeing.

This research was led by Elizabeth Carpenter-Song, PhD, and Anne Sosin, MPH