Urban areas have a higher concentration of healthcare resources, including clinics, hospitals, specialized medical services, and emergency services. The geographical proximity to these facilities allows for people across socioeconomic statuses to have access to a broader range of healthcare services with convenience. These services can lead to more timely and accurate diagnoses, treatments, and care. Urban areas have better public health infrastructure such as disease control, water quality, and sanitation; ulitmately leading to improved health outcomes. Moreover, the presence of medical research institutions further improves the quality of care available in cities. 

Furthermore, urban areas have more favorable conditions of social determinants of health such as - education levels, strong social support networks, environmental conditions, and employment opportunities - all of which leading to healthier lifestyles and improved access to preventative healthcare. These factors reduce the rates of chronic disease and increase the life expectancy in urban areas. These benefits are not evenly distributed; with low-income and marginalized individuals  still facing significant barriers to healthcare, however these disparities are mitigated by the urban environment in which they reside. This overall availability of resources provide urban areas with a healthcare advantage over rural areas, where resources are often scarce and sometimes even absent. 

Source: (The urban health “advantage".)

Higher morbidity and mortality rates are driven by several interconnected factors. Residents of rural areas often engage in riskier health behaviors, such as higher rates of smoking, heavy drinking, and poor dietary habits, this is partially due to the lack of health education and general preventative services. The inaccessibility of healthcare services exacerbates these issues, rural areas sometimes lack adequate and quality medical facilities, leading to delayed diagnoses and treatments. Moreover, socioeconomic barriers including lower income levels and higher rates of underinsured individuals, limit access to crucial care. Leading to poorer health outcomes and increased rates of chronic diseases. 

Healthcare providers in rural areas face unique challenges that exacerbate these diaprities. Geographic isolation means that patients often need to travel long distances to receive care, making emergency situations and routine check-ups very difficult. Financial hardship is another barrier, as rural healthcare providers may struggle with higher operational costs and lower patient volume, making sustaining essential services difficult. Cultural barriers also play a significant role, with some rural populations mustrusting the healthcare system, or having different healthcare beliefs or approaches that may deter them from seeking care. 

Source: (Rural and Urban Health)

Community organizations play a crucial role in mitigating healthcare disparities by providing culturally tailored support through community health workers (CHWs) and other local advocates. In both rural and urban settings, CHWs serve as crucial links between healthcare providers and underserved populations, bridging gaps in access to care. These workers are oftentimes apart` of the communities they serve, allowing them to build trust and effectively communicate health information in manners that are receptable with local cultural norms and values. Their roles are especially impactful in areas where there is a shortage of healthcare professionals or where residents may be hesitant to seek care due to cultural or language barriers. 

In rural areas, CHWs address the issues of geographic isolation and inadequate healthcare infrastructure by providing essential health education and direct advocacy. They assist their clients with navigating potentially complex healthcare systems, and connect patients with available resources. In urban settings where healthcare disparities may be derived from socioeconomic inequities or systemic racism, CHWs and biingual support staff play a vital role in ensuring that non-english speaking residents and marginalized communities receive adequate care. These workers overall help to increase health literacy, reduce language barriers, and advocate for the needs of their communities, ulitmately leading to improved health outcomes and reduced disparities in both urban and rural populations. 

Source: (Addressing Health Disparities in the Rural United States: Advocacy as Caregiving among Community Health Workers and Promotores de Salud)

Rural areas can be described as healthcare deserts, where access to medical services is severely limited due to the challenges faced by local hospitals and clinics. Rural hospitals that are within 30-60 miles of an urban area with a major medical center frequently struggle to compete with their larger counterparts. Resources and staff, including specialized medical professionals, often migrate toward urban centers, leaving rural hospitals with fewer resources and a diminished ability to operate effectively. This migration exacerbates operational difficulties, leading to the closure of rural hospitals, which further strains the already limited healthcare infrastructure in these communities.

The impact of these closures extends beyond just healthcare, affecting various areas of rural life. Residents are forced to travel long distances, often hours, to access necessary medical care in urban areas, creating significant barriers for those without access to reliable transportation. This "doughnut effect," where resources concentrate in urban centers while surrounding rural areas are left with inadequate services, drastically lowers the quality of healthcare available to rural residents. The closure of rural hospitals also undermines the economic vitality of these communities, leading to a decline in local businesses and schools, as well as the migration of healthcare staff to other areas. To address these challenges, solutions such as mobile health clinics, telehealth services, and healthcare conglomeration have been proposed to expand access to care in rural communities, but the effectiveness of these interventions greatly varies. 

Source: (Why health care is still hard to access in rural towns near Texas’ bigger cities ; Rural Hospitals Struggle to Keep Their Doors Open)

Addressing healthcare deserts in rural areas requires holistic approaches that go beyond merely increasing the number of healthcare providers or facilities. While healthcare conglomeration, such as cross-market mergers, can help keep rural practices open by pooling resources under a common business, this approach also has drawbacks. The corporatization of healthcare often drives up costs, making services inaccessible to some populations. Therefore, solutions must focus on not only increasing resources in rural populations but also ensuring that healthcare remains affordable and accessible to everyone. Additionally, there is a need to promote and support local hospitals in rural communities. Programs that address healthcare distrust and challenge the bias favoring urban healthcare quality over rural healthcare are essential for making a lasting impact. 

To create sustainable changes in rural healthcare, it’s important to tackle the root causes of resource shortages. For instance, increasing Medicare reimbursement and coverage in rural areas could ensure that facilities receive adequate funding and do not operate at a deficit. However, healthcare disparities in rural areas are exacerbated by broader issues, such as income inequality, food insecurity, and homelessness. Holistic solutions must address both the lack of funding and resources in healthcare facilities and the lifestyle factors that make rural populations more vulnerable to poor health outcomes. Understanding why rural populations tend to experience poorer health than their urban counterparts is crucial in developing comprehensive strategies that truly improve health outcomes in these underserved areas.

Source: (Better Texas rural health care access depends on collaboration, experts say)