May 2021
Rural health care challenges

Residents of Pennsylvania rural communities often face different health challenges than those who live in cities. Rural county physicians like Dr. George Garrow see the challenges first-hand. Garrow is the chief medical officer of The Primary Health Network, a federally qualified health center based in Mercer County. Federally qualified health centers are part of a program of the Health Resources and Services Administration. Garrow is also a community representative with Penn State Clinical and Translational Science Institute. The institute values the insights and opinions of community members to guide its mission within Penn State and inform about the needs of our Pennsylvania communities.


Garrow: Even before the pandemic, healthcare access was becoming increasingly challenging for individuals who live in rural communities. The whole hospital industry has changed, and small-town community hospitals aren’t the same as when I was younger. It’s not uncommon for folks who live in rural communities to drive long distances to access care. Community Health Centers are very well positioned to be in those communities to help to serve as best we possibly can by being available.

The Primary Health Network has a charitable foundation arm that supports transportation in many small rural communities. We recognize that limited transportation is a social determinant that impacts a person’s health. If you can’t get there to where the healthcare is being delivered, that represents a significant barrier. So, we offer transportation services at many of our locations to try to break down those barriers.


Garrow: I think access to testing has been a challenge in rural communities. Early on, I was taught, and I believe that testing should be accessible, available and appropriate. And part of the problem is, is the test available in rural communities? In urban areas, there may be options for testing when you need it, but it’s not always so readily available in rural settings.

When an individual is either diagnosed with COVID or is in close contact with someone positive for COVID, quarantining is important to help mitigate the virus’s further spread. There are some hurdles and obstacles for individuals to quarantine in urban and rural settings but perhaps more exemplified in rural communities because they may not have the ability to access food. We worry when we ask someone to quarantine, “Are you warm? Are you safe? Can you connect with individuals?”


Garrow: We have a very tight close working relationship with Penn State Shenango. We help with education and training of the students that are there. We’re doing several projects together. One of the most exciting initiatives that we’re doing with them is an outreach to the Amish community. Here in Mercer County and the counties surrounding where I live, we have a relatively large Amish community. They have been hit very hard by COVID, not necessarily from an infection standpoint but just limiting access.

We’re relying heavily on telehealth and virtual visits. Because of their religious beliefs, they don’t have access to technology in the home. One of the really interesting projects that we’re working on is how do we get the technology to them to use during their virtual care? And so, we’re working with a team at Penn State Shenango to do outreach.

Addressing COVID-19 vaccine hesitancy in Pennsylvania, with a particular focus on the Latino population and senior citizens aged 65 and older in rural communities, is the objective of a project spearheaded by Penn State Extension.

The Extension Collaborative on Immunization Teaching and Engagement — EXCITE, for short — is a joint effort between the nation’s Cooperative Extension System and the Centers for Disease Control.

The Penn State College of Nursing’s SAFE-T Center team, led by assistant professor and center director Sheridan Miyamoto, is working to address barriers to health care for rural sexual assault victims with their telehealth solution, the SAFE-T System.

According to the center, there are more than 284,000 victims of sexual assault across America every year. Victims require timely, skilled, and compassionate health care to address injuries, risk of pregnancy, and sexually transmitted infections. Additionally, forensic evidence must be collected accurately and methodically to aid in the successful prosecution of perpetrators. Current technology used to aid in magnification, image capture, and secure storage is expensive and requires substantial technical expertise to administer.

Do you know about the Office of Rural Health?

The Pennsylvania Office of Rural Health was formed in 1991 as a partnership between the federal government, the Commonwealth of Pennsylvania, and Penn State. The office is one of 50 state offices of rural health in the nation funded through the Federal Office of Rural Health Policy under the U.S. Department of Health and Human Services and the Pennsylvania Department of Health.

The state offices of rural health are charged with being a source of coordination, technical assistance, and networking; partnership development; and assisting in the recruitment and retention of health care providers.

At Penn State, the Office of Rural Health is administratively located in the Department of Health Policy and Administration in the College of Health and Human Development.

The office provides expertise in the areas of rural health, agricultural health and safety, oral health, and community and economic development.

What is Penn State Extension?

Penn State Extension is dedicated to delivering science-based information to people, businesses, and communities. It provides access to face-to-face and online education to Pennsylvania citizens to help them address problems and take advantage of opportunities for improvement and innovation. Partnering with and funded by federal, state, and county governments, it has a long tradition of providing unbiased support and education. Topics include 4-H youth development, agronomy and natural resources, animal systems, health, food safety and horticulture. Learn more.
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This publication was supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TR002014. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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