Rural racial disparities persist during pandemic

The coronavirus pandemic has highlighted not only rural health and economic disparities, but racial disparities as well—especially for rural people of color.

Rural Covid-19 death rates have outstripped metropolitan rates since September, but rural people of color have had it even worse. "From March 2020 through February, rural residents experienced 175 Covid-19 deaths per 100,000 people, compared with 151 deaths per 100,000 for urban communities. And in highly diverse rural counties where people of color made up at least a third of the population, 258 people died per 100,000," according to a recent report from management consultant firm McKinsey & Company, Aallyah Wright reports for Stateline. "In rural counties where the largest racial group was American Indian or Alaska Native, the overall death rate was 2.1 times that of White rural counties. In rural counties where Black people predominated, the overall death rate was 1.6 times that in White rural counties. And in largely Hispanic rural counties, the death rate was 1.5 times higher than the White rate."

Rural Americans are less likely than their urban and suburban counterparts to have easy access to health care for a number of reasons, including hospital closures, transportation issues, and lack of affordable health insurance. They're also more likely to live in states that haven't expanded Medicare under the Patient Protection and Affordable Care Act, and they're more likely to be older, poorer, and have underlying health problems—all of which contribute to higher Covid-19 mortality rates. "The situation is especially dire for rural people of color, who have higher rates of premature deaths, poverty and chronic diseases and more often lack health insurance," Wright reports.

Rural and urban racial disparities during the pandemic stem from "long-standing systemic inequalities and structural racism," according to a recent Department of Health and Human Services report. Public-health experts say tackling those issues, especially expanding Medicaid, would make a big difference for low-income rural people of color, Wright reports.