Implications of U.S. health care reform for the rural elderly

Health care services for elders living in rural areas have been limited by inadequate financing, lack of awareness of existing services, insufficient numbers of providers, and geographic dispersion of rural residents. Not all proposals for health care reform would help reduce these barriers, however. Nurses working in rural areas can facilitate the evolution of the health care system in several ways. A primary mechanism is the development and implementation of nurse-managed centers, networking with existing agencies and services to provide outreach programs to the underserved rural elders. Another mechanism is participation in professional organizations that lobby for rural health concerns. A third strategy is participation in program evaluation and intervention studies with policy-relevant implications. It is an exciting era for nurses involved in rural health and an opportune time to promote effective health care for older adults who live in rural areas.